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Sleep dysregulation common in patients with Huntington's disease

Thursday, December 13 2007 | Comments
Evidence Grade 0 What's This?
A new study reveals that sleep disturbances and daytime somnolence are common in patients with Huntington's disease, and researchers suggest that neurodegenerative processes may play a role in the development of sleep dysregulation.

Currently, little is known about sleep disorders and daytime somnolence in patients with HD, the authors noted.

The trial included 30 patients (median age, 50 years) with HD and without dementia. Median disease duration was 7 years. Quality of sleep, daytime somnolence, and associated risk factors were assessed using the Pittsburg Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Beck Depression Inventory (BDI), and the Mini-Mental State Examination (MMSE).

In 23 patients, researchers obtained a collateral sleep history. They also gathered information on the use of antidepressants, sleep aids, and antipsychotic medications.

The Unified Huntington's Disease Rating Scale revealed a median motor score of 26, a median bradykinesia subscore of 5, and a median chorea score of 6. Median total functional capacity among the participants was 6.5.

Overall, 70% of the patients had abnormal sleep, defined as a global PSQI of ≥5. The median global PSQI was 6.5. Half of the patients had daytime somnolence, defined as an ESS score of ≥10. A diagnosis of REM behavior disorder was suspected in 23% of the patients. Sixty percent of the patients snored, and median sleep latency was 20 minutes.

In all, 77% of the patients took antidepressants and 50% took antipsychotic medications, while 17% used sleep aids. The researchers found a positive association between daytime somnolence and current depression (P=0.028). Longer disease duration and abnormal sleep were significantly associated, as well (P=0.039).

Because of the association between longer disease duration and abnormal sleep, the authors speculated that intrinsic neurodegenerative processes may adversely affect sleep-wake regulation in these patients. In addition, they concluded that adequate treatment of depression in patients with HD may help improve sleep quality and daytime somnolence. (Videnovic A, et al. P05.053.)

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