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Sleep Disturbances in Patients with Disorders of the Nerve and Muscle Diseases

  • Jorge L. Morales-Estrella
  • Loutfi S. AboussouanEmail author
Sleep and Neurological Conditions (A Avidan, Section Editor)
  • 2 Downloads
Part of the following topical collections:
  1. Topical Collection on Sleep and Neurological Conditions

Abstract

Purpose of Review

Recognize sleep disorders associated with neuromuscular diseases.

Recent Findings

Neuromuscular diseases can be associated with various sleep disorders. Diaphragmatic weakness, bulbar dysfunction, pharyngeal neuropathy, and central neurodegeneration cause sleep-disordered breathing. Spinal cord hyperexcitability, loss of inhibitory descending pathways, and neuropathy promote restless legs syndrome. Reduced cerebrospinal fluid (CSF) hypocretin, central dysfunction of sleep regulation, and degeneration of GABAergic intracortical circuits may contribute to central hypersomnia. Dysfunction of the nigrostriatal dopaminergic system, associated with neurodegenerative diseases and certain neuromuscular disorders, may be a common pathophysiologic mechanism responsible for the loss of rapid eye movement (REM) sleep muscle atonia and REM sleep behavior disorder (RBD).

Summary

Different neuromuscular disorder may be more susceptible to specific sleep disturbances. A low threshold needs to be maintained for the diagnosis and treatment of sleep disorders in neuromuscular diseases, due to their high prevalence, lack of symptom specificity, and presence even in minimally symptomatic patients. However, loss of REM atonia may be protective against sleep-disordered breathing. There are reasonable pathophysiologic mechanisms such as respiratory muscle weakness, upper airway obstruction, and central dysfunction that explain the link between sleep disorders and neuromuscular diseases

Keywords

Neuromuscular diseases Sleep-disordered breathing Restless legs syndrome Periodic limb movements Disorders of excessive somnolence 

Notes

Funding Information

Loutfi S. Aboussouan has received royalties from UpToDate/Wolters Kluwer for authorship of chapters unrelated to the topic discussed here.

Compliance with Ethical Standards

Conflict of Interest

Jorge L. Morales-Estrella declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jorge L. Morales-Estrella
    • 1
  • Loutfi S. Aboussouan
    • 1
    Email author
  1. 1.Respiratory InstituteCleveland ClinicClevelandUSA

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