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This article, published in the journal Thorax, explores the effects of non-invasive ventilation (NIV) on sleep in chronic hypercapnic respiratory failure. It discusses the impact of chronic respiratory diseases on sleep quality and the potential role of NIV in improving health-related quality of life. The article also highlights the physiological changes that occur during sleep in patients with conditions such as chronic obstructive pulmonary disease (COPD), obesity-related respiratory failure (ORRF), and neuromuscular disorders (NMD). It emphasizes the importance of monitoring sleep quality in patients using long-term NIV and the need for further research to fully understand the effects of NIV on sleep quality. The document provides a list of references that cover studies on the relationship between sleep quality and various respiratory conditions, including COPD, obesity-related hypoventilation syndrome, and neuromuscular diseases. These references offer valuable information for researchers and healthcare professionals working with these patient populations. [Extracted from the article]

Sniff nasal inspiratory pressure (SNIP) is used to assess respiratory muscle strength in neuromuscular diseases like amyotrophic lateral sclerosis (ALS). The effect of contralateral nostril occlusion and mouth sealing on SNIP measurement are unclear. 81 participants were included (16 healthy, 39 patients with limb-onset ALS and 26 patients with bulbar-onset ALS). SNIP was obtained with combinations of mouth open/sealed and contralateral nostril open/occluded. Occluding the contralateral nostril (with mouth closed) increased SNIP by 12 cmH 2 O (95% CI 4, 20; p=0.003) in the healthy participants, by 9 cmH 2 O (95% CI 5, 12; p<0.001) in the limb-onset cohort and by 10 cmH 2 O (95% CI 5, 14; p<0.001) in the bulbar-onset cohort. Opening the mouth decreased SNIP by 19 cmH 2 O (95% CI 5, 34; p<0.009) in healthy participants, by 8 cmH 2 O (95% CI 4, 13; p<0.001) in the limb-onset cohort and by 13 cmH 2 O (95% CI 7, 19; p<0.001) in the bulbar-onset cohort. With contralateral nostril occlusion, 11% fewer individuals would have qualified for non-invasive ventilation. In conclusion, contralateral nostril occlusion increased SNIP compared with standard technique, likely reflecting true strength. Opening the mouth reduced SNIP, emphasising the need for good mouth sealing. Documenting SNIP technique is important for longitudinal assessments and clinical decision-making., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)