Standard of Practice vs Polysomnography-Directed Nocturnal Non-Invasive Positive Pressure Ventilation in Preserving Respiratory Function and Quality of Life in ALS

Columbia University Medical Center, New York

Hypothesis:
We hypothesize that NIV titrated and adjusted using PSG to objectively address the nocturnal breathing needs of ALS patients will be significantly more efficacious than NIV prescribed and adjusted without such objective titration in preserving diurnal respiratory function, as well as in preserving quality of life.

Aim:
To prospectively determine, in ALS patients who are prescribed nocturnal NIV as per current practice parameters, whether PSG titrated and adjusted NIV (P-NIV) is associated with improved preservation of diurnal respiratory function and quality of life over the course of the first 6 months after prescription of NIV, compared with standard of practice prescription and adjustment of NIV (S-NIV). Ancillary aims are to determine to what extent the prescription for P-NIV differs from S-NIV; whether respiratory function is improved in the morning following a night of P-NIV compared with S-NIV; to what extent S-NIV is associated with failure of nocturnal oxygenation and/or ventilation; and if P-NIV use is associated with improved survival, compared with S-NIV use.

Status:
Patients will be recruited from Columbia University Medical Center