Prevalence and clinical correlates of sleep disturbances in hemifacial spasm: A multi-centre case-control study
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Sahil Mehta1, Niraj Kumar2, Sweety Kumari3
1Dept. of Neurology, Post graduate Institute of Medical Education and Research, Chandigarh, India.
Background:
Hemifacial spasm (HFS) is a chronic movement disorder characterised by involuntary contractions of muscles on one side of the face. While motor features are well recognised, sleep disturbances in HFS have not been studied in detail.
Objective:
We aimed to compare the prevalence of sleep disturbances between HFS patients and healthy controls and examine clinical factors associated with sleep dysfunction in HFS.
Methods:
This cross-sectional case-control study included 133 HFS patients and 227 age- and gender-matched healthy controls. Validated questionnaires were used to assess excessive daytime sleepiness (EDS), sleep quality, insomnia, restless legs syndrome (RLS), probable rapid eye movement sleep behaviour disorder (pRBD), and high risk of obstructive sleep apnea (OSA). Anxiety, depression, and quality of life were assessed. HFS severity was assessed using the Hemifacial Spasm Grading Scale.
Results:
Compared to healthy controls, HFS patients had a greater prevalence of EDS (P = 0.003), poor sleep quality (P < 0.001), moderate-to-severe insomnia (P < 0.001), pRBD (P = 0.007), RLS (P < 0.001), high risk for OSA (P = 0.005), depression (P = 0.009), and lower quality of life (P < 0.001). Multivariate analysis showed that poor sleep quality was associated with anxiety; RLS with HFS severity, and high risk for OSA with a higher body mass index (BMI) and hypertension, among patients with HFS. Poor quality of life in HFS was associated with presence of poor sleep quality, pRBD, RLS, anxiety, and depressive symptoms.
Conclusions:
Sleep disturbances are common in HFS, and are associated with disease severity, high BMI, and anxiety. Sleep and mood symptoms worsen quality of life in these patients.
