Comorbid Sleep Disturbances in Neurologic Disorders

Yo-El S. Ju, MD, MSCI; Aleksandar Videnovic, MD, MSc, FAAN, FAASM; Bradley V. Vaughn, MD, FAAN, FAASM Sleep Neurology p. 1117-1131 August 2017, Vol.23, No.4 doi: 10.1212/CON.0000000000000501
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Purpose of Review: This article provides a review of disturbances of sleep comorbid with common neurologic disorders.

Recent Findings: A wide variety of neurologic disorders are frequently complicated by comorbid sleep disturbances. In many cases, a bidirectional relationship appears to occur between sleep function and the neurologic disease, such that treatment of comorbid sleep disturbances may improve the symptoms of the neurologic disease.

Summary: Neurologic disorders are often associated with abnormalities of sleep. Sleep influences the severity of both epilepsy and headache, and treatment of comorbid sleep disorders may improve seizure and headache frequency. Alzheimer disease is characterized by circadian phase delay and poor nighttime sleep and is strongly associated with obstructive sleep apnea. Parkinson disease is associated with several sleep disorders, including insomnia, restless legs syndrome, rapid eye movement (REM) sleep behavior disorder, daytime hypersomnia, and sleep-disordered breathing. Hypoventilation in amyotrophic lateral sclerosis and other neuromuscular disorders often presents initially with sleep problems, and treatment with noninvasive ventilation improves survival and quality of life.

Address correspondence to Dr Yo-El S. Ju, Washington University in St. Louis, 600 South Euclid Ave, Box 8111, St. Louis, MO 63110, [email protected].

Relationship Disclosure: Dr Ju has received personal compensation for serving as a speaker and moderator for the American Academy of Neurology, as a speaker for the American Academy of Sleep Medicine and the World Association of Sleep Medicine, and as a consultant of C2N Diagnostics. Dr Ju has received research/grant support from the National Institutes of Health and as principal investigator of a study for Philips Respironics. Dr Videnovic serves on the editorial board of Parkinsonism & Related Disorders and has received personal compensation for serving as chair of the data and safety monitoring board of Acorda Therapeutics and for serving on the data and safety monitoring board of Wilson Therapeutics. Dr Videnovic has received research grants from the National Institute of Neurological Disorders and Stroke and receives royalties from Springer International Publishing AG. Dr Vaughn has received personal compensation as a speaker for the American Academy of Neurology, American Academy of Sleep Medicine, and Medical Education Resources and receives royalties from Medlink Neurobase and UpToDate, Inc. Dr Vaughn has received personal compensation for serving as chair of the sleep medicine examination committee of the American Board of Internal Medicine.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Ju discusses the unlabeled/investigational use of trazodone to treat comorbid sleep disturbances in dementia. Drs Videnovic and Vaughn report no disclosures.

Copyright © 2017 by the American Academy of Neurology.