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Insomnia is frequent in amyotrophic lateral sclerosis at the time of diagnosis

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Abstract

Sleep-disordered breathing and sleep-related symptoms are frequent in patients with severe amyotrophic lateral sclerosis (ALS). We aimed to describe sleep quality, sleep structure, and the occurrence of sleep-disordered breathing in patients with early ALS, at the time of initial evaluation in a tertiary care center. Sleep-related symptoms were collected using questionnaires, the Pittsburgh Sleep quality Index (PSQI), and the Epworth Sleepiness Scale. Sleep was studied by inpatient overnight polysomnography. Fourteen men and 13 women (age 66 ± 12 years, ALSFRS-R 39 ± 6) were included, among which 12 patients had disease with bulbar onset. Eighteen (69%) patients complained of insomnia, fifteen of which (55%) reported poor sleep quality (PSQI > 5). No patient had an Epworth Sleepiness Scale > 10. Respiratory and polysomnography characteristics were similar between patients with poor or good sleep quality. Sleep efficiency and REM sleep duration were normal relative to normative values, while wake after sleep onset was increased. Fifteen patients had obstructive sleep apnea syndrome (8 mild, 3 moderate, and 4 severe). No patient had central apnea syndrome. Insomnia was highly prevalent in patients with early ALS, independent of respiratory impairment. Poor sleep quality was strongly associated with insomnia.

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Funding

This research has no funding source.

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Authors and Affiliations

  1. Centre Constitutif SLA, Service de Neurologie, CHRU de Tours, Tours, France

    Mathilde Choquer, Stéphane Beltran, Salah Eddine Bakkouche & Philippe Corcia

  2. Service de Biochimie et Biologie Moléculaire, CHRU de Tours, Tours, France

    Helene Blasco

  3. Université de Tours, Tours, France

    Helene Blasco, Laurent Plantier & Philippe Corcia

  4. Service de Pneumologie, CHRU de Tours, Tours, France

    Laurent Plantier

  5. CEPR/Inserm UMR1100, Tours, France

    Laurent Plantier

  6. INSERM UMR 1253, iBrain, Université de Tours, Tours, France

    Helene Blasco & Philippe Corcia

  7. Centre de Compétence de Sommeil, Service de Neurologie, CHRU de Tours, Tours, France

    Nadège Limousin

  8. Centre de Référence SLA, CHRU de Tours, Tours, France

    Nadège Limousin

Authors
  1. Mathilde Choquer
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  2. Helene Blasco
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  3. Laurent Plantier
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  4. Stéphane Beltran
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  5. Salah Eddine Bakkouche
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  6. Philippe Corcia
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  7. Nadège Limousin
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Contributions

MC, SB, SEB, and NL collected the data. MC, LP, and NL drafted the manuscript. MC, HB, SB, LP, PC and NL made substantial contributions to study design, analyzed the data, and critically reviewed the manuscript.

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Correspondence to Nadège Limousin.

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The authors declare no competing interests.

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The authors state that the manuscript has been read and approved by all the authors, that the requirements for authorship have been met, and that each author believes that the manuscript represents honest work.

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Patients were informed that data were used for research purposes and gave oral consent according to French law on retrospective observational studies.

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Choquer, M., Blasco, H., Plantier, L. et al. Insomnia is frequent in amyotrophic lateral sclerosis at the time of diagnosis. Sleep Biol. Rhythms 19, 121–126 (2021). https://doi.org/10.1007/s41105-020-00296-4

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  • DOI: https://doi.org/10.1007/s41105-020-00296-4

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