Sleep disturbances in probable multiple system atrophy

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2024-10-10 DOI:10.1016/j.sleep.2024.10.013

Malligurki Raghurama Rukmani , Ravi Yadav , Binukumar Bhaskarapillai , Pramod Kumar Pal , Talakad Narasappa Sathyaprabha

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引用次数: 0

Abstract

Background

Multiple system atrophy (MSA) is a fatal alpha-synucleinopathy characterized by variable combinations of parkinsonism, autonomic and cerebellar dysfunction. Sleep in MSA is highly compromised due to various sleep disturbances. Disrupted sleep-wake cycles in MSA contribute to poor health-related quality of life and are negative prognostic factors.

Objectives

We aimed to study the various sleep disturbances; the effect of parkinsonian and cerebellar phenotypes on sleep; and the correlation of sleep parameters with disease severity in an Asian-Indian cohort of probable MSA patients.

Methods

We recruited 60 probable MSA patients (MSA-P = 19; MSA-C = 41). Disease severity was assessed using UPDRS-III, UMSARS-I and UMSARS-II. Detailed history and relevant sleep questionnaires were applied to evaluate the sleep disturbances.

Results

Sleep disturbances were universally observed in probable MSA patients in this cohort. These include REM behavior disorder (RBD)-95 %; poor sleep quality-80 %; secondary insomnia and intermittent awakenings-100 %; excessive daytime sleepiness-26 %; risk for obstructive sleep apnea-51.7 % and snoring-85 %. MSA patients reported 38.2 ± 22.9 percentage improvement in sleep with the medications. There was no significant difference between probable MSA-P and MSA-C patients in any of the sleep parameters. Sleep quality was poor in patients with pre-motor RBD than post-motor RBD (p < 0.01). Poor sleep quality had a moderate positive correlation with RBD duration. Disease severity positively correlated with RBD duration and poor sleep quality.

Conclusions

Sleep disturbances, the negative prognostic factors, were universally observed in this Asian Indian MSA cohort. This study provides supporting evidence that RBD might play a possible role in MSA disease severity, progression, and sleep quality.

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疑似多系统萎缩症患者的睡眠障碍

背景多系统萎缩（MSA）是一种致命的α-突触核蛋白病，其特征是帕金森病、自主神经和小脑功能障碍的不同组合。由于各种睡眠障碍，MSA患者的睡眠受到严重影响。我们的目的是研究各种睡眠障碍；帕金森病和小脑表型对睡眠的影响；以及亚洲-印度疑似 MSA 患者队列中睡眠参数与疾病严重程度的相关性。方法我们招募了 60 名疑似 MSA 患者（MSA-P = 19；MSA-C = 41）。疾病严重程度通过UPDRS-III、UMSARS-I和UMSARS-II进行评估。结果在本组疑似 MSA 患者中普遍观察到睡眠障碍。这些障碍包括快速眼动行为障碍（RBD）-95%；睡眠质量差-80%；继发性失眠和间歇性觉醒-100%；白天过度嗜睡-26%；阻塞性睡眠呼吸暂停风险-51.7%和打鼾-85%。据报告，MSA 患者使用药物后睡眠改善率为 38.2 ± 22.9%。可能患有 MSA-P 的患者和患有 MSA-C 的患者在任何睡眠参数上都没有明显差异。运动前 RBD 患者的睡眠质量比运动后 RBD 患者差（p < 0.01）。睡眠质量差与 RBD 持续时间呈中度正相关。疾病严重程度与 RBD 持续时间和睡眠质量差呈正相关。本研究提供了支持性证据，证明 RBD 可能在 MSA 疾病严重程度、进展和睡眠质量中扮演了重要角色。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.