Sleep disorders in multiple system atrophy: a correlative video-polysomnographic study.

Area of Science:

• Neurology
• Sleep Medicine
• Respiratory Medicine

Background:

• Multiple system atrophy (MSA) is a neurodegenerative disease affecting multiple systems.
• Sleep disturbances are common in MSA, but their relationship with autonomic and motor systems is not fully understood.

Purpose of the Study:

• To investigate the relationship between breathing, heart, and motor system abnormalities during sleep in MSA patients.
• To compare these abnormalities with those found in obstructive sleep apnea syndrome (OSAS).

Main Methods:

• Video-polysomnography (VPSG) was performed on 19 MSA patients and 10 OSAS patients.
• VPSG included sleep scoring, respiratory abnormalities, heart rate (HR), breathing rate (BR), and motor activity assessment.
• EMG activity of respiratory muscles and tibialis anterior was analyzed.

Main Results:

• All MSA patients exhibited snoring; 42% had stridor and 37% had OSAS.
• MSA patients showed impaired breathing (mean SaO2 92.7%, lowest 86%) and increased BR and HR during sleep, particularly with stridor.
• Frequent abnormal EMG activity in respiratory and limb muscles, REM sleep behavior disorder (RBD), and periodic limb movements during sleep (PLMS) were observed in MSA patients.

Conclusions:

• MSA patients frequently present with impaired breathing and abnormal respiratory and limb muscle control during sleep.
• The co-occurrence of breathing and motor abnormalities in MSA suggests a widespread disruption of sleep regulation.
• These sleep-related findings should be considered in the diagnostic criteria for MSA.