Study Of Sleep In Neuromyelitis Optica

Objective To study the clinical characteristics of sleep abnormalities in NMO patients.Methods1.Thirty patients with NMO were enrolled from Aug2013to Feb2014,and were devided into two subgroups:with infretenterial and without infretenterial lesion based on clinical data.Fifteen controls were enrolled.2.NMO patients and normal controls were monitored by nocturnal polysomnography (PSG).3.Quality of life,Quality of sleep, daytime sleepiness, fatigue and depression were assessed by Activity of daily living scale (ADL),Pittsburgh sleep quality index scale (PSQI),Epworth sleepiness scale(ESS),Fatigue scale-14(FS-14) and Beck Depression Inventory (BDI).Results1.Objective indicators of sleep(1) Sleep structure:When compared to healthy controls, NMO patients had obvious decreases in sleep efficiency (78%vs87%, p=0.006), non-REM sleep N3(7.8%vs16.3%, p=0.000), and arousal index (5.36vs10.01, p=0.039); non-REM sleep N1prominent increased (16.5%vs9.7%, p=0.003),non-REM sleep N2had no significance (59.50%vs58.67%, p=0.791),and rapid-eye-movement (REM) sleep had no significance(16.20%vs15.47%, p=0.708) between two groups.(2) Respiratory events:Compared to healthy controls.NMO patients had prominent decreases in mean SpO2(93.93vs96.47, p=0.000),the proportion of abnormal AHI was higher in NMO group(20.00%vs6.67%, p=0.395).(3) Limb movement:Compared to healthy controls.NMO patients had prominent increases in periodic limb movement (PLM) index (17.87vs0.75, p=0.015).(4) Comparison between MNO subgroups:There was no significance between the two subgroups in sleep structure.Compared to the subgroup without infretenterial lesion.the subgroup with infretenterial lesion had a higher level in mean SpO2(95.08 vs93.06, p=0.048),no significance in AHI(1.12vs6.98, p=0.145),and prominent increases in periodic limb movement (PLM) index(37.52vs2.84, p=0.025).2.Subjective indicators of sleep(1) Compared to healthy controls,NMO patients had prominent increases in ADL score(28.37vs20.13, p=0.000).There was no significance in PSQI score between the two groups (7.93vs6.40, p=0.345),and also no significance in ESS score(6.40vs6.40, p=1.000).NMO patients had significant decreases in Fatigue Scale(8.43vs20.13, p=0.002).and prominent increases in Beck Depression Inventory(12.93vs5.27, p=0.000).(2) Through Spearman correlation tests,there was closely correlation between Fatigue scale score and PSQI score(r=0.20,p=0.02),and between Beck Depression Inventory score and PSQI score(r=0.15,p=0.04) in NMO patients.(3)Comparison between MNO subgroups:there was no significance between the two subgroups in subjective indicator of sleep.Conclusion1.Compared to healthy controls,NMO patients had prominent significance in objective indicators of sleep, obvious decreases in sleep efficiency and arouse index, and disorders in sleep structure.2.Compared to healthy controls,NMO patients had decreases in mean SpO2,and a tendency of increases in AHI.3.Compared to healthy controls,NMO patients had prominent increases in PLM index.4.Compared to healthy controls.NMO patients had no significance in subjective indicators of sleep.there was closely correlation between Fatigue scale score and PSQI score,and between Beck Depression Inventory score and PSQI score in NMO patients.5.Compared to subgroup without infretentorial lesion,the subgroup with infretentorial lesion had prominent increases in PLM index and mean SpO2. There was no significance between the two subgroups in sleep structure,AHI and subjective indicators of sleep.