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Sleep in Functional Motor Disorders: A Case-Control Polysomnographic Study.

Jiří Nepožitek1, Simona Dostálová1, Martin Jirásek1,2

  • 1Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.

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Summary

Functional motor disorders (FMD) patients exhibit significant sleep disturbances, including common sleep disorders and altered REM sleep, impacting their quality of life. Objective polysomnography revealed sleep structure changes, highlighting the need to address sleep issues in FMD management.

Keywords:
REM sleepfunctional motor disorderfunctional movement disorderfunctional neurological disordermovement disorderspolysomnography

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Area of Science:

  • Neurology
  • Sleep Medicine
  • Psychiatry

Background:

  • Sleep problems are prevalent in functional motor disorders (FMD).
  • Objective sleep correlates and comorbidities in FMD remain understudied.
  • No prior polysomnography studies exist for FMD sleep assessment.

Purpose of the Study:

  • To investigate polysomnographic sleep parameters in FMD patients.
  • To correlate objective sleep findings with self-reported sleep and mood symptoms.
  • To identify comorbid sleep disorders in FMD.

Main Methods:

  • 37 FMD patients and 37 controls underwent polysomnography.
  • Structured medical and sleep histories were collected.
  • Questionnaires assessed sleep quality, sleepiness, depression, and anxiety.

Main Results:

  • FMD patients reported worse sleep quality, higher sleepiness, depression, and anxiety.
  • Polysomnography revealed longer REM sleep latency, worse sleep efficiency, and increased wake ratio in FMD.
  • Common sleep disorders included restless legs syndrome (32%), obstructive sleep apnea (38%), and periodic limb movements in sleep (8%).
  • Subjective sleep quality and sleepiness correlated with depression and anxiety, but not with objective polysomnographic measures.

Conclusions:

  • FMD is associated with objective sleep structure changes, particularly involving REM sleep.
  • Sleep abnormalities, including REM sleep impairments, are crucial considerations in FMD management.
  • Further research is needed to explore the role of REM sleep disturbances in FMD pathophysiology.