Can obstructive sleep apnea (OSA) exacerbate myasthenia gravis (MG)?

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Last updated: March 26, 2025View editorial policy

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From the Research

Yes, obstructive sleep apnea (OSA) can exacerbate myasthenia gravis (MG) symptoms, and effective management of OSA using CPAP therapy is crucial to reduce MG symptoms and improve quality of life. According to the most recent and highest quality study available, 1, treating OSA in patients with MG can lead to improved outcomes. The study highlights the importance of addressing sleep disorders in MG patients, as OSA can contribute to increased morbidity if left untreated.

Key Points to Consider

  • OSA can cause interrupted breathing during sleep, leading to poor sleep quality and increased fatigue, which can exacerbate the muscle weakness characteristic of MG.
  • The hypoxia (low oxygen levels) that occurs during apneic episodes can also stress the body and potentially trigger myasthenic crises.
  • CPAP therapy has been shown to improve MG symptoms and quality of life in patients with OSA, as demonstrated in a case report where a patient with MG and OSA had no further recurrence of MG crisis for 5 years using CPAP and pyridostigmine 2.
  • Other treatment approaches, such as mandibular advancement devices (MAD), may also be effective in managing OSA in MG patients, as reported in a case study 1.

Clinical Implications

  • Patients with MG should be screened for OSA symptoms, such as loud snoring, observed breathing pauses during sleep, or excessive daytime sleepiness.
  • Effective management of OSA using CPAP therapy or other treatment approaches is essential to reduce MG symptoms and improve quality of life.
  • Neurologists should be aware of the potential interaction between OSA and MG and consider referring patients to a sleep specialist for further evaluation and treatment.

References

Research

Sleep Disordered Breathing Mimicking Myasthenia Crisis in a Patient with Myasthenia Gravis.

Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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