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Polysomnographic abnormalities in succinic semialdehyde dehydrogenase (SSADH) deficiency
Phillip L Pearl1, Sadat Shamim, William H Theodore
1Neuroscience Center, CNMC, George Washington University School of Medicine, Washington, DC, USA. ppearl@cnmc.org
Objectives:
Patients with SSADH deficiency, a disorder of chronically elevated endogenous GABA and GHB, were studied for sleep symptoms and polysomnography. We hypothesized that patients would have excessive daytime somnolence and decreased REM sleep.
Design:
Polysomnography and MSLT were performed on patients enrolled for comprehensive clinical studies of SSADH deficiency.
Setting:
Sleep studies were obtained in the sleep laboratories at CNMC and NIH.
Patients:
Sleep recordings were obtained in 10 patients with confirmed SSADH deficiency.
Interventions:
Thirteen overnight polysomnograms were obtained in 10 patients (7 male, 3 female, ages 11-27 y). Eleven MSLT studies were completed in 8 patients.
Measurements And Results:
Polysomnograms showed prolongation of REM stage latency (mean 272 +/- 89 min) and decreased percent stage REM (mean 8.9%, range 0.3% to 13.8%). Decreased mean sleep latency was present in 6 of 11 MSLTs.
Conclusions:
SSADH deficiency is associated with prolonged latency to stage REM and decreased percent stage REM. This disorder represents a model of chronic GABA and GHB accumulation associated with suppression of REM sleep.
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