GBS is an acute inflammatory demyelinating polyradiculoneuropathy characterized by rapidly progressive muscle paresis and numbness of the extremities. Rapid respiratory deterioration is a short-term yet, serious complication that results from bulbar, inspiratory, and expiratory muscle weakness. Bulbar dysfunction, auto-nomic instability, and early progression to disability predict development of respiratory paralysis in GBS (68). Although the prevalence of OSA or other respiratory disturbance during sleep has not been reported in GBS patients, respiratory compromise and failure may occur at anytime during the day or sleep. Continuous oxygen monitoring and frequent checks of vital capacity during the day and night in an intensive-care unit (ICU) setting are paramount to patient care during the acute phase of illness. The use of bilevel pressure support in two GBS patients with early deterioration of their respiratory systems was unsuccessful in preventing emergency intubation (69). Therefore, the use of CPAP or BPAP should not be a substitute for ICU admission and anticipation of emergency intubation. Whether patients develop OSA or other SRBD months or years later is unknown.
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