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Stridor during sleep: description of 81 consecutive cases diagnosed in a tertiary sleep disorders center
Sleep ( IF 5.6 ) Pub Date : 2020-09-21 , DOI: 10.1093/sleep/zsaa191 Cristiana Silva 1 , Alex Iranzo 1 , Gerard Maya 1 , Mónica Serradell 1 , Amaia Muñoz-Lopetegi 1 , Paula Marrero-González 1 , Carles Gaig 1 , Joan Santamaría 1 , Isabel Vilaseca 2
Sleep ( IF 5.6 ) Pub Date : 2020-09-21 , DOI: 10.1093/sleep/zsaa191 Cristiana Silva 1 , Alex Iranzo 1 , Gerard Maya 1 , Mónica Serradell 1 , Amaia Muñoz-Lopetegi 1 , Paula Marrero-González 1 , Carles Gaig 1 , Joan Santamaría 1 , Isabel Vilaseca 2
Affiliation
OBJECTIVE
To describe the characteristics of stridor during sleep (SDS) in a series of adults identified by video-polysomnography (V-PSG). METHODS
Retrospective clinical, V-PSG, laryngoscopic and therapeutic data of patients diagnosed with SDS in a tertiary referral sleep disorders center between 1997 and 2017. RESULTS
Eighty-one patients were identified (56.8% males, age 61.8 ± 11.2 years). Related etiologies were multiple system atrophy (MSA), amyotrophic lateral sclerosis, spinocerebellar ataxia type 1, anti-IgLON5 disease, fatal familial insomnia, brainstem structural lesions, vagus nerve stimulation, recurrent laryngeal nerve injury, the effect of radiotherapy on the vocal cords, cervical osteophytes and others. Stridor during wakefulness coexisted in 13 (16%) patients and in MSA was only seen in the parkinsonian form. Laryngoscopy during wakefulness in 72 (88.9%) subjects documented vocal cord abductor impairment in 65 (90.3%) and extrinsic lesions narrowing the glottis in two (2.4%). The mean apnea-hyponea index (AHI) was 21.4 ± 18.6 and CT90 was 11.5 ± 19.1. Obstructive AHI>10 occurred in 52 (64.2%) patients and central apnea index >10 in two (2.4%). CPAP abolished SDS, obstructive apneic events and oxyhemoglobin desaturations in 58 of 60 (96.7%) titrated patients with optimal pressure of 9.0 ± 2.3 cm H20. Tracheostomy in 19 (23.4%) and cordotomy in three (3.7%) subjects also eliminated SDS. CONCLUSIONS
SDS in adults is linked to conditions that damage the brainstem, recurrent laryngeal nerve and vocal cords. V-PSG frequently detects obstructive sleep apnea and laryngoscopy usually shows vocal cord abductor dysfunction. CPAP, tracheostomy and laryngeal surgery abolish SDS.
中文翻译：
睡眠期间喘鸣：描述在三级睡眠障碍中心诊断的连续 81 例
目的 描述一系列通过视频多导睡眠图 (V-PSG) 识别的成人睡眠期间喘鸣 (SDS) 的特征。方法 1997 年至 2017 年在三级转诊睡眠障碍中心诊断为 SDS 的患者的回顾性临床、V-PSG、喉镜和治疗数据。结果 确定了 81 名患者（56.8% 男性，年龄 61.8 ± 11.2 岁）。相关病因包括多系统萎缩 (MSA)、肌萎缩侧索硬化症、1 型脊髓小脑共济失调、抗 IgLON5 疾病、致死性家族性失眠、脑干结构病变、迷走神经刺激、喉返神经损伤、放疗对声带的影响、颈椎骨赘等。清醒期间的喘鸣在 13 名 (16%) 患者中并存，并且在 MSA 中仅以帕金森病形式出现。72 名 (88.9%) 受试者清醒期间的喉镜检查记录了 65 名 (90.3%) 的声带外展损伤和 2 名 (2.4%) 的外源性病变使声门变窄。平均呼吸暂停低通气指数 (AHI) 为 21.4 ± 18.6，CT90 为 11.5 ± 19.1。52 名（64.2%）患者发生阻塞性 AHI>10，2 名（2.4%）患者中枢性呼吸暂停指数>10。CPAP 在 60 名滴定患者中的 58 名 (96.7%) 中消除了 SDS、阻塞性呼吸暂停事件和氧合血红蛋白饱和度下降，最佳压力为 9.0 ± 2.3 cm H2O。19 名 (23.4%) 的气管切开术和 3 名 (3.7%) 的脐带切开术也消除了 SDS。结论 成人 SDS 与损伤脑干、喉返神经和声带的疾病有关。V-PSG 经常检测阻塞性睡眠呼吸暂停，喉镜检查通常显示声带外展肌功能障碍。呼吸机，
更新日期：2020-09-21
中文翻译：
睡眠期间喘鸣：描述在三级睡眠障碍中心诊断的连续 81 例
目的 描述一系列通过视频多导睡眠图 (V-PSG) 识别的成人睡眠期间喘鸣 (SDS) 的特征。方法 1997 年至 2017 年在三级转诊睡眠障碍中心诊断为 SDS 的患者的回顾性临床、V-PSG、喉镜和治疗数据。结果 确定了 81 名患者（56.8% 男性，年龄 61.8 ± 11.2 岁）。相关病因包括多系统萎缩 (MSA)、肌萎缩侧索硬化症、1 型脊髓小脑共济失调、抗 IgLON5 疾病、致死性家族性失眠、脑干结构病变、迷走神经刺激、喉返神经损伤、放疗对声带的影响、颈椎骨赘等。清醒期间的喘鸣在 13 名 (16%) 患者中并存，并且在 MSA 中仅以帕金森病形式出现。72 名 (88.9%) 受试者清醒期间的喉镜检查记录了 65 名 (90.3%) 的声带外展损伤和 2 名 (2.4%) 的外源性病变使声门变窄。平均呼吸暂停低通气指数 (AHI) 为 21.4 ± 18.6，CT90 为 11.5 ± 19.1。52 名（64.2%）患者发生阻塞性 AHI>10，2 名（2.4%）患者中枢性呼吸暂停指数>10。CPAP 在 60 名滴定患者中的 58 名 (96.7%) 中消除了 SDS、阻塞性呼吸暂停事件和氧合血红蛋白饱和度下降，最佳压力为 9.0 ± 2.3 cm H2O。19 名 (23.4%) 的气管切开术和 3 名 (3.7%) 的脐带切开术也消除了 SDS。结论 成人 SDS 与损伤脑干、喉返神经和声带的疾病有关。V-PSG 经常检测阻塞性睡眠呼吸暂停，喉镜检查通常显示声带外展肌功能障碍。呼吸机，
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