Background: Effective treatments for obstructive sleep apnoea (OSA) include positive pressure, weight loss, oral appliances, surgery, and exercise. Although the involvement of the respiratory muscles in OSA is evident, the effect of training them to improve clinical outcomes is not clear. We aimed to determine the effects of respiratory muscle training in patients with OSA. Methods: A systematic review was conducted in seven databases. Studies that applied respiratory muscle training in OSA patients were reviewed. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence. Results: Of the 405 reports returned by the initial search, eight articles reporting on 210 patients were included in the data synthesis. Seven included inspiratory muscle training (IMT), and one included expiratory muscle training (EMT). Regarding IMT, we found significant improvement in Epworth sleepiness scale in −4.45 points (95%CI −7.64 to −1.27 points, p = 0.006), in Pittsburgh sleep quality index of −2.79 points (95%CI −4.19 to −1.39 points, p < 0.0001), and maximum inspiratory pressure of −29.56 cmH₂O (95%CI −53.14 to −5.98 cmH₂O, p = 0.01). However, the apnoea/hypopnea index and physical capacity did not show changes. We did not perform a meta-analysis of EMT due to insufficient studies. Conclusion: IMT improves sleepiness, sleep quality and inspiratory strength in patients with OSA.

Objective: To investigate the relationship between respiratory function, functionality, and mortality in amyotrophic lateral sclerosis (ALS) patients and to determine which respiratory parameters show the strongest correlation with functionality and mortality. Methods: The study was conducted in Rio Grande do Norte, Northeast Brazil, between January 2018 and December 2023. This was a retrospective cohort, following individuals with ALS who were evaluated at the University Laboratory. Results: A total of 74 ALS patients were included in the analysis, with a mean age of 55.7 ± 13.5 years. Most were male (66.2%) and predominantly presented with spinal-onset ALS (51.3%). Respiratory variables (except peak expiratory flow (PEF)) showed a weak but significant inverse correlation with mortality (FVC% predicted (r_pb = −0.260; p < 0.001), SNIP (r_pb = −0.235; p = 0.001), MEP (r_pb = −0.207; p = 0.007), MIP (r_pb = −0.198; p = 0.009), and PEF% predicted (r_pb = −0.156; p = 0.013)). When analyzing their correlation with ALSFRS-R, all variables showed a significant positive correlation (ranging from weak to moderate) with functionality. A reduction of one unit in the respiratory variables PEF% of predicted, maximal inspiratory pressure (MIP), and sniff nasal inspiratory pressure (SNIP) increased the risk of death by an average of 300% (OR = 2.99; 95% CI: 2.05–4.35), 2% (OR = 1.02; 95% CI: 1.01–1.03), and 1% (OR = 1.01; 95% CI: 1.00–1.02), respectively. Conclusions: Our findings suggest that direct measurements of respiratory function and muscle strength, particularly PEF and SNIP, may serve as more useful markers to guide early interventions such as non-invasive ventilation, thereby improving quality of life and potentially prolonging survival.

Background/Objectives: Amyotrophic Lateral Sclerosis (ALS) is a progressive and fatal neurodegenerative disease characterized by motor neuron loss, muscle weakness, and respiratory dysfunction, often culminating in ventilatory failure. Evidence suggests that High-Definition Transcranial Direct Current Stimulation (HD-tDCS) may modulate motor cortical excitability and potentially influence motor and respiratory function in ALS. This study aims to evaluate the effects of home-based HD-tDCS applied over the primary diaphragmatic motor cortex on respiratory parameters and disease progression in individuals with ALS. Methods: This is a multicenter, randomized, controlled clinical trial. Eligible participants (aged 18–80, both sexes, diagnosed with ALS) will be randomized into an active HD-tDCS group (gTDCS) or a sham group (gSham). The intervention consists of 30 min daily HD-tDCS sessions (3 mA) applied for two weeks (5 days/week), using a 4 × 1 ring configuration targeting the diaphragmatic motor cortex. Sham stimulation includes an identical setup but only delivers ramp currents (30 s) with a minimal ongoing current (0.1 mA). Results: Pre-, intra-, and post-intervention evaluations will include measures of cortical excitability, cerebral and tissue perfusion, surface electromyography, respiratory and pulmonary function, fatigue, sleep quality, pain, motor performance, dyspnea, quality of life, and adverse effects. All procedures will be conducted at participants’ homes with appropriate safety monitoring. Conclusions: This study will investigate the effects of HD-tDCS on respiratory and motor function in ALS and explore the feasibility of a home-based neuromodulation intervention. The outcomes may provide insight into non-pharmacological strategies for respiratory management in ALS.

1. Respiratory diseases encompass a broad spectrum of conditions, from acute infections to chronic disorders, that exert a profound impact on global health [1,2]. Acute respiratory illnesses such a...

In Chile, the SOA strategy was created in 2003, focusing on the paediatric population, who present stable respiratory pathologies, and who only require oxygen for hospital discharge. Aim: To describe the experience of the last 10 years of the Chilean Ministry of Health's SOA for children. Methods: Retrospective analysis of electronic records of patients admitted to the children's ambulatory oxygen therapy service of the Chilean Ministry of Health since 2022. Demographic characterization, diagnoses, type of equipment used and oxygen flow, time of indicated use, history of use of mechanical ventilation, nutritional status, among others, were performed. Descriptive statistics were used for the statistical analysis with Stata 11.2 software. Results: In the last 10 years 8741 patients have been admitted(59.5% male), mean age at admission 1.4 years (Des 4.4; range 0-19 years), bronchopulmonary dysplasia (BPD) 57.5%, post-viral lung damage (PVD) 11.6%, cardiopulmonary malformations 5.8%, sequelae of aspiration pneumonia, central nervous system damage 5.92%, neuromuscular disease 2.3%, cystic fibrosis 1.17, ventilatory support 2.22%, others 13.5%. According to equipment used: cylinder 93.23%, concentrator 2.94% and O. Liquid 3.82%. Deceased patients 10.6% not associated with problems with the SOA. Discharges 67.15% and current treatment 21.52%. Indicated flow rate 0.1 lts/min 48.18%; 0.5 lts/min 15.05%, 0.25 lts/min 11.19%, other flow rates 25.58%. 84.16% permanent use and 15.84% only at night. Conclusions: The main diagnoses of admission are BPD and CPD. SOA has proven to be a safe public health strategy that significantly reduces healthcare costs.