Sleep and neuromuscular disorders.

Polysomnographic evaluation in the sleep laboratory is recommended for patients with neuromuscular disorders who develop symptoms and sign of sleep-wake abnormality or nocturnal respiratory failure. Nocturnal sleep-related ventilatory alterations may occur in disproportion to the severity of the neuromuscular disorder. Diaphragmatic paralysis occurring in the context of a neuromuscular disorder is often an overlooked complication. Failure to thrive, daytime tiredness, and incapacitating fatigue may be the result of a potentially correctable sleep-related abnormality and not due to relentless progression of the neuromuscular condition. Application of CPAP and BiPAP and administration of supplemental oxygen are relatively simple, noninvasive, ambulatory, therapeutic maneuvers that may correct sleep-related ventilatory alterations in patients with neuromuscular disorders.