Sleep disorders in patients with autoimmune encephalitis (AE) are increasingly reported. Early recognition and treatment have significant importance regarding the potential of sleep disorders’ effect on morbidity and even mortality. There are a limited number of studies related to polysomnography (PSG) in these patients. Here, we report the clinical and PSG data of patients with AE and sleep disorders, with a particular interest in sleep-related breathing disorders (SRBD).
Seventeen patients with diagnosed AE and acute or subacute onset sleep complaints who underwent video-electroencephalography-PSG recordings in our tertiary center were investigated.
The mean age was 50, with eight females and nine males. The detected antibodies were against leucine-rich glioma-inactivated 1(LGI-1) in 6, anti-contactin-associated protein-2(CASPR2) in 3, voltage-gated potassium channel complex antigens(VGKC) in 1, anti-glycine in 1, dipeptidyl-peptidase-like protein-6(DPPX) in 1, anti-Hu in 1, and anti-amphiphysin in 1. All commercially available and known autoimmune encephalitis-related antibodies were negative in 3 of the patients. Final diagnosis after PSG was circadian rhythm sleep disorder (n = 3), periodic limb movement disorder (n = 3), insomnia (n = 5), central apnea with or without Cheyne–Stokes breathing (CSB) (n = 4), obstructive sleep apnea (OSA) (n = 4), non-rapid eye movement (NREM) and REM parasomnia (n = 8), faciobrachial dystonic seizures (n = 2), and subclinical seizures (n = 1). Sleep microstructure was disrupted in 9, REM periods without atonia occurred in 4, and brief sleep fragments consisting of theta activity interspersed with faster rhythms existed in 7 patients. Nearly half of our patients (47%) had SRBD, and the mean apnea–hypopnea index (AHI) was 14.
Sleep disorders are frequent and essential components of AEs. Systematic clinical questionnaires and routine PSG assessments would significantly impact the correct diagnosis and proper treatment of SRBD and the overall prognosis of AE.
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American Academy of Sleep Medicine
Anti-neuronal nuclear antibody 2
Collapsin-response mediator protein 5
Central sleep apnea
Delta/notch-like epidermal growth factor-related receptor
Dipeptidyl-peptidase-like protein- 6
Excessive daytime sleepiness
- GAD 65:
Glutamic acid decarboxylase 65
Leucine-rich glioma-inactivated 1
Magnetic resonance imaging
Non-rapid eye movement
Obstructive sleep apnea
Purkinje cell antibody 1
Periodic limb movements
Rapid eye movement
Sry-like high mobility group box 1
Statistical Package for the Social Sciences
Sleep-related breathing disorder
Total sleep time
Voltage-gated potassium channel complex
Zinc finger protein 4
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Hacettepe University Non-interventional Clinical Researches Ethics Board.
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Erkent, I., Elibol, B., Saka, E. et al. Sleep disorders and polysomnography findings in patients with autoimmune encephalitis. Neurol Sci 44, 1351–1360 (2023). https://doi.org/10.1007/s10072-022-06513-x