As Duchenne muscular dystrophy (DMD) progresses, muscle deterioration impairs cardiac and pulmonary function. The spine becomes curved and loss of respiratory strength leads to breathing difficulties. Sleep-disordered breathing in DMD is a common symptom of impaired respiratory function, causing interrupted sleep, morning headaches, daytime sleepiness and more serious complications if not effectively treated.
What is DMD?
Duchenne muscular dystrophy (DMD) is a rare genetic muscular disorder that is mostly found in male children aged 3 to 6 years. It causes the body’s muscles to progressively weaken and atrophy, affecting gait, mobility and eventually leading to heart or respiratory failure. There is currently no cure for DMD and the average life expectancy is 18 to 25 years. Treatment focuses on symptom management and improving quality of life.
What is sleep-disordered breathing?
Sleep-disordered breathing occurs when the diaphragm and other respiratory muscles are weakened, which makes it more difficult to breathe when lying down. This means that people living with DMD breathe too shallowly or too slowly (called hypoventilation), which deprives the body of oxygen and increases carbon dioxide levels. Low levels of oxygen in the blood can cause low energy and sleepiness during the day, as well as headaches and other symptoms.
Sleep apnea due to airway obstruction, weight gain or prolonged use of corticosteroids is also common in DMD. People with sleep apnea repeatedly stop breathing throughout the night, and don’t get restful sleep.
Diagnosing sleep-disordered breathing in DMD
A diagnosis of sleep-disordered breathing in DMD is difficult to establish based on sleep history or diaries. It is accurately diagnosed by an overnight sleep study, or polysomnography (PSG), with capnometry to assess oxygen levels, sleep apnea and patterns of breathing throughout the night.
Regular monitoring by your health care team as well as lung function tests can help prevent the onset of sleep-disordered breathing. Early detection and treatment are essential for the best outcomes.
If sleep-disordered breathing in DMD is not detected and treated, it can affect daytime breathing and upright ventilation. This can eventually lead to acute respiratory failure, causing death.
Learn more about DMD treatment and care
Managing sleep-disordered breathing in DMD
Following a diagnosis of sleep-disordered breathing in DMD, treatment and symptom management are designed to stop nocturnal breathing difficulties from worsening.
- Non-invasive ventilation: Using a bilevel positive airway pressure (BiPAP) or continuous airway pressure (CPAP) machine at night can help improve quality of sleep and well-being. These machines help push air into the airway during sleep.
- Weight management: Weight gain due to physical inactivity is common in DMD and can lead to sleep apnea.
- Adapted sleeping position: Elevating the head while lying down can increase airflow and help improve breathing.
Sign up here to get the latest news, perspectives, and information about DMD sent directly to your inbox. Registration is free and only takes a minute.
