Sleep in Patients With Neurologic Disease

Sara E. Benjamin, MD Sleep Neurology p. 1016-1033 August 2020, Vol.26, No.4 doi: 10.1212/CON.0000000000000887
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PURPOSE OF REVIEW This article provides a discussion of the current evidence and contemporary views on the relationship between sleep disorders and neurologic disease.

RECENT FINDINGS Disrupted or disordered sleep can be associated with increased morbidity and mortality, the risk of cardiovascular events, increased seizure frequency, and altered immune responses. Studies have implicated disrupted sleep and circadian rhythm dysfunction with both amyloid-β (Aβ) deposition and tau deposition. A bidirectional relationship exists between disrupted sleep and the progression of Alzheimer disease pathology. Insomnia has been reported as a prodromal symptom in autoimmune encephalitis. Primary sleep disorders have now been increasingly recognized as a common comorbid condition in multiple sclerosis, making it imperative that neurologists feel comfortable differentiating multiple sclerosis fatigue from excessive daytime sleepiness caused by primary sleep disorders to optimally treat their patients.

SUMMARY Sleep disorders are common across the population. By recognizing sleep disorders in patients with neurologic conditions, neurologists can provide comprehensive care and, in some cases, reduce neurologic disease burden.

Address correspondence to Dr Sara E. Benjamin, Johns Hopkins Center for Sleep, 11085 Little Patuxent Pkwy, Ste 210, Columbia, MD 21044, sbenjam4@jhmi.edu.

RELATIONSHIP DISCLOSURE: Dr Benjamin has received personal compensation for a grand rounds presentation for Mercy Medical Center; as a narcolepsy agent formulary review consultant for OptumRx, Inc; and for occasional surveys for BioPharm, Compass, Inc, Everyday Health Group, GLG, InCrowd, Inc, J Reckner Associates, Inc, M3 Global Research, Olson Research Group, Research Now Group, LLC, Schlesinger Group, and WebMD, LLC.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Benjamin reports no disclosure.

© 2020 American Academy of Neurology.