Dados do Trabalho

Título

MÜLLER MANOEUVRE IN PATIENTS WITH PARKINSON'S DISEASE UNDER INVESTIGATION FOR OBSTRUCTIVE SLEEP APNEA - AN ANALYSIS IN THE BRAZILIAN AMAZON

Introdução

Parkinson's Disease (PD) is a neurodegenerative disorder, the second most common among the elderly, and the leading cause of parkinsonism.

Obstructive Sleep Apnoea (OSA) is a sleep-related breathing disorder characterised by the total or partial cessation of airflow during sleep, accompanied by hypoxia and recurrent awakenings. Flexible nasopharyngolaryngoscopy provides a direct view of the anatomical structures of the upper airways (UAW), allowing for the identification of obstructions, septal deviations, and hypertrophy of the tonsils and tongue base.

The inclusion of the Müller manoeuvre in the evaluation offers a dynamic perspective of the UAW during maximal inspiration. This procedure is performed with the patient awake, seated, under induced coughing and respiratory manoeuvres. To define the degree of retropalatal closure (RC), Grade I was classified as 0-24%, Grade II as ≥25-49%, Grade III as ≥50-74%, and Grade IV as ≥75%.

Objetivo

To analyse retropalatal closure (RC) during the MM in patients with PD under investigation for OSA and to correlate these findings with polysomnographic (PSG) data.

Métodos

The study is a cross-sectional observational study that lasted 12 months. The sample comprises patients treated at a reference hospital in Manaus, Amazonas. The study was approved by the Research Ethics Committee under Certificate of Ethical Appreciation Presentation No. 58684622.2.0000.0007.

Resultados

A total of 18 individuals were selected for the data contingency analysis between retropalatal closure (RC) during the MM and the diagnosis from PSG. Of these, 3 (16.6%) had Grade I RC, with 1 (33.3%) diagnosed with Primary Snoring and 2 (66.7%) with mild OSA. Among the 3 (16.6%) with Grade II RC, 2 (66.7%) had Primary Snoring and 1 (33.3%) had moderate OSA.

Of the 8 (44.4%) with Grade III RC, 4 (50.0%) had Primary Snoring, 1 (12.5%) had Primary Snoring and RBD, 2 (25.0%) had mild OSA, and 1 (12.5%) had severe OSA. Of the 4 (22.3%) with Grade IV RC, 1 (25.0%) had Primary Snoring, 2 (50.0%) had mild OSA, and 1 (25.0%) had moderate OSA. The p-value was 0.7962.

Conclusões

Different degrees of OSA and sleep disorders were diagnosed across all levels of retropalatal closure (RC) during the Müller Manoeuvre, indicating nonspecific results when the manoeuvre is performed on awake patients. Further data, with a larger sample size, are needed to establish a more accurate correlation between these variables.

Palavras -chave

Sleep Apnea, Obstructive; Parkinson Disease; Sleep; Pharynx; Inflammation