—The patient described by Thorpy et al1 is clearly different from any of the patients with Prader-Willi syndrome in our study. Their patient with adult-onset muscular atrophy was unable to sustain the supine position "for more than a few minutes because of dyspnea." For this patient "the maximum duration of sleep without an arousal was two minutes," resulting in a sleep efficiency of only 44%. In contrast, we did not observe any relationship between any type of breathing difficulty and arousal.2 In fact, in the one patient whose oxygen saturation was monitored, the desaturation observed continued during REM sleep for ten to 15 minutes without an arousal. During this time the oxygen saturation levels were maintained below 50%.Also, there was no evidence that a SOREMP, which was present in five of our patients, resulted from chronic REM sleep deprivation due to REMrelated hypoventilation. The overall disturbance of
Vela-Bueno A, Kales A, Soldatos CR. Sleep in the Prader-Willi Syndrome-Reply. Arch Neurol. 1985;42(2):110. doi:10.1001/archneur.1985.04060020016004
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