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Does multiple system atrophy itself affect sleep structure?

Hyunwoo Nam1, Yoon-Ho Hong, Hyung-Min Kwon

  • 1Department of Neurology, Boramae Hospital, College of Medicine, Seoul National University, Seoul, Korea.

The Neurologist
|September 11, 2009
PubMed
Abstract

Insights

Multiple system atrophy (MSA) itself does not alter sleep architecture. However, patients with MSA experience reduced total sleep time and efficiency, independent of common sleep disorders.

Area of Science:

  • Neurology
  • Sleep Medicine
  • Neurodegenerative Diseases

Background:

  • Sleep disturbances are frequently reported in multiple system atrophy (MSA), but confounding factors like obstructive sleep apnea and periodic limb movements often obscure the direct impact of MSA on sleep.
  • Previous studies have yielded inconsistent results due to these common co-occurring conditions.

Purpose of the Study:

  • To investigate the intrinsic effects of multiple system atrophy (MSA) on sleep parameters by controlling for common confounding sleep disorders.
  • To differentiate sleep changes directly attributable to MSA from those caused by obstructive sleep apnea and periodic limb movements during sleep.

Main Methods:

  • A comparative polysomnography study was conducted on 15 patients with MSA and 15 age-, gender-, apnea-hypopnea index-, and periodic limb movements index-matched controls.
  • Cyclic alternating pattern (CAP) scoring was additionally applied to a subset of 7 MSA patients and 7 controls to assess sleep microstructure.

Main Results:

  • Patients with MSA exhibited significantly reduced total sleep time and sleep efficiency compared to controls.
  • Prolonged wake after sleep onset, increased sleep onset latency, and longer stage 2 latency were observed in the MSA group.
  • No significant differences were found in the proportion of slow wave sleep or rapid eye movement sleep between MSA patients and controls.
  • Cyclic alternating pattern analysis revealed no differences in sleep microstructure between the two groups.

Conclusions:

  • Multiple system atrophy (MSA) does not appear to intrinsically alter the macro- or micro-architecture of sleep.
  • Despite the lack of structural sleep changes, patients with MSA demonstrate reduced overall sleep duration and efficiency.
  • These sleep reductions in MSA are not explained by the presence of obstructive sleep apnea or periodic limb movements during sleep.

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