Les investigations respiratoires nocturnes chez le patient en situation de polyhandicap

The lack of nocturnal investigation of people with multiple disabilities prevents us from detecting pathologies like sleep apnea and global alveolar hypoventilation. These two deficiencies have serious consequences on the quality of these patients’ life. In order to actually do this evaluation, we suggest a six-step approach: first, the spotting of suggestive clinical signs, then the consultation between the patient – with his close relatives – and the healthcare practitioners. At that point, the process can be stopped insofar as there is no will to set up additional treatment. If on the contrary, the patient's life project matches with the possibility of a ventilatory treatment, further examination can be planned: the screening, with a tool as simple as nocturnal saturometry, then the diagnostic with HAS-recommended tools, polygraph and capnographic tests. Last but not least, the ventilator treatment's setting up by an experts’ team ends the process, once all the other possible options have been evaluated. A regular revaluation will enable us to reset the ventilation and above all to draw up an assessment of the global gains and losses, to eventually stop the treatment at any moment if need be, that is to say whenever the disadvantages exceed the benefits.