Reader Response: Sleep-disordered breathing in adult patients with mitochondrial diseases: A cohort study
TomoyukiKawada, Professor, Nippon Medical School
Submitted January 13, 2021
Primiano et al. evaluated the association between sleep-disordered breathing (SDB) and clinical variables in 103 patients with mitochondrial diseases.1 SDB was demonstrated in 49 patients. The adjusted odds ratios of muscle weakness and male sex for SDB was significantly increased. Although half of patients with mitochondrial diseases presented with SDB, patients with central sleep apnea were rare in this population. I have two comments about their study.
The authors conducted a cross-sectional study to investigate the association of clinical variables with SDB, and two risk factors were identified. Although the number of events was 49, this number is at the limit of the sample size for including four independent variables in a regression model.2 Although the authors described the word "cohort" in the title, and the word "prospective" in the abstract and methods, this is a cross-sectional study. If they intend to clarify the predictors for SDB in patients with mitochondrial diseases, the number of events should be increased to keep stable estimates.
Mosquera et al. reported that there was a significant association between decreased muscle tone and SDB.3 They recommended that early detection of SDB in children with mitochondrial disease should be considered for conducting sleep-related interventions. Furthermore, prospective studies are required to determine the effect of primary mitochondrial diseases on subsequent SDB incidence.4
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Primiano G, Brunetti V, Vollono C, et al. Sleep-Disordered Breathing in Adult Patients With Mitochondrial Diseases: A Cohort Study. Neurology. 2021;96(2):e241-e249. doi:10.1212/WNL.0000000000011005
Vittinghoff E, McCulloch CE. Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol. 2007;165(6):710-718. doi:10.1093/aje/kwk052
Mosquera RA, Koenig MK, Adejumo RB, et al. Sleep disordered breathing in children with mitochondrial disease. Pulm Med. 2014;2014:467576. doi:10.1155/2014/467576
Ramezani RJ, Stacpoole PW. Sleep disorders associated with primary mitochondrial diseases. J Clin Sleep Med. 2014;10(11):1233-1239. Published 2014 Nov 15. doi:10.5664/jcsm.4212
Primiano et al. evaluated the association between sleep-disordered breathing (SDB) and clinical variables in 103 patients with mitochondrial diseases.1 SDB was demonstrated in 49 patients. The adjusted odds ratios of muscle weakness and male sex for SDB was significantly increased. Although half of patients with mitochondrial diseases presented with SDB, patients with central sleep apnea were rare in this population. I have two comments about their study.
The authors conducted a cross-sectional study to investigate the association of clinical variables with SDB, and two risk factors were identified. Although the number of events was 49, this number is at the limit of the sample size for including four independent variables in a regression model.2 Although the authors described the word "cohort" in the title, and the word "prospective" in the abstract and methods, this is a cross-sectional study. If they intend to clarify the predictors for SDB in patients with mitochondrial diseases, the number of events should be increased to keep stable estimates.
Mosquera et al. reported that there was a significant association between decreased muscle tone and SDB.3 They recommended that early detection of SDB in children with mitochondrial disease should be considered for conducting sleep-related interventions. Furthermore, prospective studies are required to determine the effect of primary mitochondrial diseases on subsequent SDB incidence.4
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References