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Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study).
Arch Neurol. 2011 Feb; 68(2):223-30.AN

Abstract

BACKGROUND

Sleep disorders are common in multiple system atrophy (MSA), but the prevalence of excessive daytime sleepiness (EDS) is not well known.

OBJECTIVE

To assess the frequency and associations of EDS in MSA.

DESIGN

Survey of EDS in consecutive patients with MSA and comparison with patients with Parkinson disease (PD) and individuals without known neurologic disease.

SETTING

Twelve tertiary referral centers.

PARTICIPANTS

Eighty-six consecutive patients with MSA; 86 patients with PD matched for age, sex, and Hoehn and Yahr stage; and 86 healthy subject individuals matched for age and sex.

MAIN OUTCOME MEASURES

Epworth Sleepiness Scale (ESS), modified ESS, Sudden Onset of Sleep Scale, Tandberg Sleepiness Scale, Pittsburgh Sleep Quality Index, disease severity, dopaminergic treatment amount, and presence of restless legs syndrome.

RESULTS

Mean (SD) ESS scores were comparable in MSA (7.72 [5.05]) and PD (8.23 [4.62]) but were higher than in healthy subjects (4.52 [2.98]) (P < .001). Excessive daytime sleepiness (ESS score >10) was present in 28% of patients with MSA, 29% of patients with PD, and 2% of healthy subjects (P < .001). In MSA, in contrast to PD, the amount of dopaminergic treatment was not correlated with EDS. Disease severity was weakly correlated with EDS in MSA and PD. Restless legs syndrome occurred in 28% of patients with MSA, 14% of patients with PD, and 7% of healthy subjects (P < .001). Multiple regression analysis (with 95% confidence intervals obtained using nonparametric bootstrapping) showed that sleep-disordered breathing and sleep efficiency predicted EDS in MSA and amount of dopaminergic treatment and presence of restless legs syndrome in PD.

CONCLUSIONS

More than one-quarter of patients with MSA experience EDS, a frequency similar to that encountered in PD. In these 2 conditions, EDS seems to be associated with different causes.

Authors+Show Affiliations

Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, University of Barcelona Medical School and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, 08036 Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

21320989

Citation

Moreno-López, Claudia, et al. "Excessive Daytime Sleepiness in Multiple System Atrophy (SLEEMSA Study)." Archives of Neurology, vol. 68, no. 2, 2011, pp. 223-30.
Moreno-López C, Santamaría J, Salamero M, et al. Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study). Arch Neurol. 2011;68(2):223-30.
Moreno-López, C., Santamaría, J., Salamero, M., Del Sorbo, F., Albanese, A., Pellecchia, M. T., Barone, P., Overeem, S., Bloem, B., Aarden, W., Canesi, M., Antonini, A., Duerr, S., Wenning, G. K., Poewe, W., Rubino, A., Meco, G., Schneider, S. A., Bhatia, K. P., ... Tolosa, E. (2011). Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study). Archives of Neurology, 68(2), 223-30. https://doi.org/10.1001/archneurol.2010.359
Moreno-López C, et al. Excessive Daytime Sleepiness in Multiple System Atrophy (SLEEMSA Study). Arch Neurol. 2011;68(2):223-30. PubMed PMID: 21320989.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study). AU - Moreno-López,Claudia, AU - Santamaría,Joan, AU - Salamero,Manuel, AU - Del Sorbo,Francesca, AU - Albanese,Alberto, AU - Pellecchia,Maria Teresa, AU - Barone,Paolo, AU - Overeem,Sebastiaan, AU - Bloem,Bastiaan, AU - Aarden,Willemijn, AU - Canesi,Margherita, AU - Antonini,Angelo, AU - Duerr,Susanne, AU - Wenning,Gregor K, AU - Poewe,Werner, AU - Rubino,Alfonso, AU - Meco,Giuseppe, AU - Schneider,Susanne A, AU - Bhatia,Kailash P, AU - Djaldetti,Ruth, AU - Coelho,Miguel, AU - Sampaio,Cristina, AU - Cochen,Valerie, AU - Hellriegel,Helge, AU - Deuschl,Günther, AU - Colosimo,Carlo, AU - Marsili,Luca, AU - Gasser,Thomas, AU - Tolosa,Eduardo, PY - 2011/2/16/entrez PY - 2011/2/16/pubmed PY - 2011/4/14/medline SP - 223 EP - 30 JF - Archives of neurology JO - Arch Neurol VL - 68 IS - 2 N2 - BACKGROUND: Sleep disorders are common in multiple system atrophy (MSA), but the prevalence of excessive daytime sleepiness (EDS) is not well known. OBJECTIVE: To assess the frequency and associations of EDS in MSA. DESIGN: Survey of EDS in consecutive patients with MSA and comparison with patients with Parkinson disease (PD) and individuals without known neurologic disease. SETTING: Twelve tertiary referral centers. PARTICIPANTS: Eighty-six consecutive patients with MSA; 86 patients with PD matched for age, sex, and Hoehn and Yahr stage; and 86 healthy subject individuals matched for age and sex. MAIN OUTCOME MEASURES: Epworth Sleepiness Scale (ESS), modified ESS, Sudden Onset of Sleep Scale, Tandberg Sleepiness Scale, Pittsburgh Sleep Quality Index, disease severity, dopaminergic treatment amount, and presence of restless legs syndrome. RESULTS: Mean (SD) ESS scores were comparable in MSA (7.72 [5.05]) and PD (8.23 [4.62]) but were higher than in healthy subjects (4.52 [2.98]) (P < .001). Excessive daytime sleepiness (ESS score >10) was present in 28% of patients with MSA, 29% of patients with PD, and 2% of healthy subjects (P < .001). In MSA, in contrast to PD, the amount of dopaminergic treatment was not correlated with EDS. Disease severity was weakly correlated with EDS in MSA and PD. Restless legs syndrome occurred in 28% of patients with MSA, 14% of patients with PD, and 7% of healthy subjects (P < .001). Multiple regression analysis (with 95% confidence intervals obtained using nonparametric bootstrapping) showed that sleep-disordered breathing and sleep efficiency predicted EDS in MSA and amount of dopaminergic treatment and presence of restless legs syndrome in PD. CONCLUSIONS: More than one-quarter of patients with MSA experience EDS, a frequency similar to that encountered in PD. In these 2 conditions, EDS seems to be associated with different causes. SN - 1538-3687 UR - https://www.unboundmedicine.com/medline/citation/21320989/Excessive_daytime_sleepiness_in_multiple_system_atrophy__SLEEMSA_study__ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneurol.2010.359 DB - PRIME DP - Unbound Medicine ER -