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I read with interest the pathophysiology study of Lipp et al,1 who found that patients with multiple system atrophy (MSA) and autonomic failure are hemodynamically impaired when stressed with hypercarbia and hypoxia, while maintaining relatively intact ventilatory responses. The authors1 mentioned a potential relevance to death during sleep in MSA.
Jaster JH. Novel Mechanisms and Preventions for Sudden Unexpected Death Related to Medullary Brain Lesions. Arch Neurol. 2010;67(10):1288. doi:10.1001/archneurol.2010.110