Clinical and polysomnographic features of patients with multiple system atrophy in Southwest China

The association between clinical features and polysomnographic variables of Chinese patients with multiple-system atrophy (MSA) remains largely unknown.

This study assessed 30 patients with MSA from Southwest China using the Unified Multiple-System Atrophy Rating Scale (UMSARS). Each patient also underwent video-polysomnography. Twenty age and gender matched healthy volunteers were performed video-polysomnography as control group.

Of the 30 patients, 23 (76.7 %) were classified as having MSA-C and seven (23.3 %) were diagnosed with MSA-P. The mean age of the patients at disease onset was 53.2 ± 8.5 years, and the mean duration of their disease was 3.6 ± 2.8 years. Twenty-one patients complained of sleep disorders. The mean scores of UMSARS-I, UMSARS-II, and UMSARS-IV of patients with MSA-P were significantly higher than those of patients with MSA-C. Polysomnography revealed that 29 patients had sleep architecture alteration. A longer duration of stage N1 sleep, a shorter REM sleep, as well as decreased sleep efficiency and total sleep time (TST) were detected. Twenty-one patients had obstructive sleep apnea. Patients with MSA-C demonstrated longer sleep onset latencies compared with patients with MSA-P. TST was negatively correlated with MSA duration, whereas sleep latency was positively correlated with MSA duration. Moreover, TST, and mean SaO2 were negatively correlated with motor disability.

Various sleep disorders are common in Chinese MSA patients. Sleep architecture and sleep-associated breathing disorders are predominant polysomnographic findings. Sleep quantity was reduced with disease progression.