A patient with decreased respiratory effort
Contributed by M. Safwan Badr, MD
What is the finding identified by the arrow?
REM-related loss of intercostal muscle activity resulting in decreased thoracic effort. The loss of intercostal muscle activity is a characteristic finding during REM sleep and results in a decreased functional residual capacity during REM sleep. In patients with marginal oxyhemoglobin saturation (SaO2) during NREM sleep, the decreased FRC results in SaO2 <90%. The decreased FRC also explains why there are larger decreases in SaO2 with apneas and hypopneas during REM sleep.
