NIV (Non Invasive Ventilation) criteria and Amyotrophic Lateral Sclerosis (ALS) Survival

Introduction: The aim of our study was to assess different criteria used to introduce NIV in ALS patients, including polysomnography (PSG) values and how it can affecttheir survival. Methods: We analyzed retrospectively 40 patients from the diagnosis of the disease to the beginning of NIV and their follow-up. We collected demographic parameters, respiratory function, respiratory symptoms, arterial blood gases and polysomnographic values. Results: We included 40 patients with ALS who received a respiratory assessment to evaluate the need of NIV. The mean age of diagnosis of the disease was 63 ± 11 years. Prior to the indication of NIV, 17 PSG studies were performed. Table 1 shows the characteristics of both groups: PSG versus non PSG group. Sleep efficiency was 49.9%, with a predominance of N1 (28.8%) and N2 (45.5%), a high index of arrousals (26.4 / h) and an obstructive AHI of 19 / h. The CT90 was 43.9%. Patients with bulbar onset had a survival of only 4 months versus 17 months of patients without bulbar onset. Patients who underwent PSG had longer survival than patients without PSG. Conclusions: The performance of PSG in ALS allows the evaluation of nocturnal respiratory failure parameters (CT90, AHI, ODI) and its behavior on sleep efficiency, which can serve as early criteria for initiating NIV and therefore help increase survival in these patients.