Abnormal Sleep in Chronic Inflammatory Demyelinating Polyneuropathy

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a dysimmune disease leading to sensorimotor deficits due to peripheral nerve dysfunction, but recently additional non-sensorimotor symptoms (NSMS) were increasingly recognized. In this context, we compared the sleep behavior in persons with versus without CIDP and discussed the results with respect to further NSMS.

Twenty-five CIDP patients and 27 controls took part in this prospective, cross-sectional study. Clinically, sensorimotor disability (RODS), affective state (DESC-I), and fatigue levels (FSMC scores) were assessed. Regarding sleep-wake behavior, they wore actigraphic devices over 14 consecutive days and completed sleep diaries, chronotype questionnaires, and the Pittsburgh Sleep Quality Index (PSQI). The actigraphic data were analyzed with respect to sleep efficiency, wake after sleep onset (WASO), sleep onset latency, total sleep duration, intradaily variability (IV), and interdaily stability (IS).

Patients with CIDP reported significantly worse subjective sleep quality (p < 0.001). They also showed higher levels of fatigue (p < 0.001) and depressiveness (p = 0.046). The actigraphic results showed significantly reduced WASO (p_bonf = 0.012), especially early in the morning and immediately preceding waking up (p = 0.010). The sleep abnormalities were not linked to the raised clinical data (p > 0.05).

Beyond subjectively reduced sleep quality, actigraphic data show that persons with CIDP have lowered sleep efficacy and experience increased nocturnal arousals. This suggests that sleep disturbance is a genuine aspect of CIDP adding to the underrecognized problem of NSMS in this condition.