Sleep disturbances in patients with myasthenia gravis: A cross-sectional study

Abstract

Objective

To explore sleep dysfunction in clinically stable patients with myasthenia gravis (MG) and to identify sleep disturbances and uncover their associated risk factors.

Methods

A cross-sectional study was conducted, involving the recruitment of 306 patients with MG from three MG centers. Participants completed an online self-report questionnaire covering demographic variables, clinical characteristics, and assessments using the Pittsburgh Sleep Quality Index (PSQI) scale, STOP-Bang scale, Myasthenia Gravis Quality of Life 15 (MG-QOL 15) scale, Patient Health Questionnaire (PHQ-9), and Self-Rating Anxiety Scale (SAS), to evaluate sleep quality among patients with MG.

Results

Approximately 68% of patients with MG presented sleep disturbances (PSQI ≥6). Univariate analysis revealed that age, lower education level (≤12 years), being single, late disease onset (>55 years old), generalized subtype, myasthenia crisis, positivity for AChR antibodies, thymoma, thymectomy, and type B thymoma were risk factors for sleep dysfunction in patients with MG. Within the sleep disturbances group, 51% of patients scored ≥3 on the STOP-Bang scale, indicating a higher risk of obstructive sleep apnea. PSQI global scores showed significant linear correlations with MG-QOL 15, STOP-Bang, PHQ-9, and SAS scores (P < .001). Multivariate analysis revealed that sex, marital status, STOP-Bang score, SAS score, and MG-QOL 15 score were correlated with the PSQI score.

Conclusion

Sleep disturbances are prevalent among patients with MG, even in clinically stable cases. Psychological factors such as anxiety and health-related quality of life warrant increased attention in the management of these patients.