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Sleep Characteristics in Pediatric Anti-N-methyl-d-aspartate (NMDA) Receptor Encephalitis: A Retrospective Cohort

Grace Gombolay1,2, Morgan Morris2, Leah Loerinc3

  • 1Department of Pediatric Neurology, Children's Healthcare of Atlanta, Atlanta, GA, USA.

Journal of Child Neurology
|May 19, 2023
PubMed

Insights

Sleep problems are common in children with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, with many experiencing persistent issues. Poor sleep at one year may indicate worse outcomes in pediatric NMDA receptor encephalitis patients.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Neuroimmunology

Background:

  • Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a rare autoimmune disorder affecting the central nervous system.
  • Sleep disturbances are a recognized symptom in various neurological conditions, but their prevalence in pediatric NMDA receptor encephalitis is not well-documented.

Purpose of the Study:

  • To investigate the incidence and persistence of sleep problems in children diagnosed with NMDA receptor encephalitis.
  • To explore the association between sleep dysfunction and clinical outcomes in this pediatric population.

Main Methods:

  • Retrospective observational cohort study utilizing a database of pediatric patients with NMDA receptor encephalitis.
  • Assessment of sleep problems at disease onset and at one-year follow-up.
  • Evaluation of one-year outcomes using the pediatric modified Rankin Scale (mRS), with scores 0-2 indicating good outcomes and scores 3+ indicating poor outcomes.

Main Results:

  • A high rate of sleep dysfunction was observed at the onset of NMDA receptor encephalitis, affecting 95% of patients.
  • Approximately 34% of patients continued to report sleep problems at the one-year follow-up.
  • Sleep problems at onset and the use of propofol were not significantly associated with poor outcomes at one year.
  • Persistent poor sleep at one year correlated with higher mRS scores (indicating poorer outcomes).

Conclusions:

  • Sleep dysfunction is a frequent and often persistent issue in children with NMDA receptor encephalitis.
  • Persistent sleep problems at one year may serve as a potential indicator of long-term neurological outcomes in pediatric NMDA receptor encephalitis.
  • Further research is warranted to elucidate the relationship between sleep disturbances and clinical outcomes in this patient group.

Keywords:
NMDAREanti-NMDA receptor encephalitisanti-NMDAREpediatricsleep

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