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‘Sleep attacks’ in patients with sleep-disordered breathing

‘Schlafattacken” in patienten mit schlafbezogenen Atmungsstörungen

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Summary

Question of the study

The term ‘sleep attack’ is used in patients with Parkinson's disease (PD) to designate a sudden onset of sleep (SOS) without any prior sleepiness. Clinically, sleep attacks can be distinguished from unintended sleep episodes, i.e. SOS with prior sleepiness. This study aimed to assess the prevalence of SOS and to identify its predictors in patients with sleep-disordered breathing (SDB).

Patients and methods

A total of 114 consecutive patients with the clinical suspicion of obstructive sleep apnoea syndrome (OSAS) and a respiratory disturbance index (RDI) of >5/h were examined using a questionnaire and polysomnography (PSG).

Results

Altogether 57.7% reported SOS, with 5.2% of the total population describing exclusively sleep attacks. SOS was observed in both patients with obstructive sleep apnoea-hypopnoea (OSAH) or increased upper airway resistance (UAR). Increased scores on the Epworth Sleepiness Scale (ESS) were the best predictor of SOS. Logistic regression showed a possible association of SOS with a low PLMS index, while no definite effect was observed for other PSG parameters.

Conclusions

Our data show that SDB is frequently associated with SOS. Future studies should address in more detail whether SDB patients with sleep attacks pose an increased accident risk.

Zusammenfassung

Fragestellung

Der Begriff “Schlafattacke” wird bei Parkinson-Patienten verwendet, um ein plötzliches Einschlafen ohne vorherige Müdigkeit zu kennzeichnen. Klinisch können “Schlafattacken” von unbeabsichtigten Schlafepisoden, d. h. einem plötzlichen Einschlafen mit vorheriger Müdigkeit, unterschieden werden. Die vorliegende Studie wurde durchgeführt, um die Prävalenz des plötzlichen Einschlafens und dessen Prädiktoren in Patienten mit schlafbezogenen Atmungsstörungen zu bestimmen.

Patienten und Methodik

114 Patienten mit der klinischen Verdachtsdiagnose eines obstruktiven Schlafapnoe-Syndroms und einem Index schlafbezogener Atmungsstörungen >5/h wurden mittels eines Fragebogens und Poly somnographie (PSG) untersucht.

Ergebnisse

Insgesamt 57,7% berichteten ein plötzliches Einschlafen, wobei 5,2% der Gesamtpopulation ausschließlich “Schlafattacken” angaben. Plötzliches Einschlafen wurde sowohl in Patienten mit einer obstruktiven Schlafapnoe bzw.-hypopnoe als auch in Patienten mit einem erhöhten Widerstand der oberen Atemwege beobachtet. Erhöhte Punktwerte auf der Epworth-Schläfrigkeitsskala stellten den besten Prädiktor für plötzliches Einschalfen dar. Ferner zeigten logistische Regressionen eine mögliche Assoziation von plötzlichem Einschlafen mit einem niedrigen PLMS-Index, während kein eindeutiger Effekt für andere PSG-Parameter gefunden wurde.

Schlussfolgerungen

Unsere Data zeigen, dass schlafbezogene Atmungsstörungen häufig mit plötzlichem Einschlafen verbunden sind. zukünftige Studien sollten detailliert klären, ob Patienten mit “Schlafattacken” eine erhöhtes Unfallrisiko aufweisen.

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Authors and Affiliations

  1. Department of Neurology, Philipps University of Marburg, Germany

    Jens Carsten Möller, Karin Stiasny-Kolster & Wolfgang Hermann Oertel

  2. Department of Internal Medicine, Philipps University of Marburg, Germany

    Werner Cassel, Andreas Jerrentrup & Heinrich F. Becker

  3. Centre for Traffic Sciences, Department of Psychology, University of Würzburg, Germany

    Yvonne Körner & Hans-Peter Krüger

Authors
  1. Jens Carsten Möller
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  2. Werner Cassel
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  3. Karin Stiasny-Kolster
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  4. Andreas Jerrentrup
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  5. Yvonne Körner
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  6. Hans-Peter Krüger
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  8. Wolfgang Hermann Oertel
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Correspondence to Jens Carsten Möller.

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Möller, J.C., Cassel, W., Stiasny-Kolster, K. et al. ‘Sleep attacks’ in patients with sleep-disordered breathing. Somnologie 9, 127–132 (2005). https://doi.org/10.1111/j.1439-054X.2005.00060.x

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  • DOI: https://doi.org/10.1111/j.1439-054X.2005.00060.x

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