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. Arch Neurol. 2011; 68(2):223-230
Excessive Daytime Sleepiness in Multiple System Atrophy (SLEEMSA Study) / Claudia Moreno, Lopez; Joan, Santamaria; Manuel, Salamero; Francesca Del, Sorbo; Alberto, Albanese; Maria Teresa, Pellecchia; Paolo, Barone; Sebastiaan, Overeem; Bastiaan, Bloem; Willemijn, Aarden; Margherita, Canesi; Angelo, Antonini; Susanne, Duerr; Gregor K., Wenning; Werner, Poewe; Alfonso, Rubino; Meco, Giuseppe; Susanne A., Schneider; Kailash P., Bhatia; Ruth, Djaldetti; Miguel, Coelho; Cristina, Sampaio; Valerie, Cochen; Helge, Hellriegel; Günther, Deuschl; Colosimo, Carlo; Marsili, Luca; Thomas, Gasser; Eduardo, Tolosa. - In: ARCHIVES OF NEUROLOGY. - ISSN 0003-9942. - 68:2(2011), pp. 223-230. [10.1001/archneurol.2010.359]
Excessive Daytime Sleepiness in Multiple System Atrophy (SLEEMSA Study)
MECO, Giuseppe;COLOSIMO, Carlo;MARSILI, LUCA;
2011
Abstract
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. Arch Neurol. 2011; 68(2):223-230I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
