Crescimanno G, et al. - In patients with amyotrophic lateral sclerosis (ALS) managed with non-invasive mechanical ventilation, researchers assessed the ability of autonomic activations to evaluate sleep fragmentation and to recognize hypopneas, as well as to assess the link between disruption of autonomic nervous system (ANS) activity and the utility of the autonomic activations as surrogates of cortical arousals. For evaluation of sleep fragmentation and for respiratory scoring in ventilated ALS patients, autonomic activations could hardly serve as surrogates of cortical arousals. A possible relation was suggested between depression of ANS activity and their poor performance.