Sleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives

Matthias BoentertDepartment of Neurology, University Hospital Muenster, Muenster, GermanyAbstract: Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease inevitably leading to generalized muscle weakness and premature death. Sleep disturbances are extremely common in patients with...

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Autor principal:	Boentert M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	amyotrophic lateral sclerosis sleep disorders sleep-disordered breathing non-invasive ventilation health-related quality of life Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/1f5fece1b7434f5e994f990be2c04a11
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spelling	oai:doaj.org-article:1f5fece1b7434f5e994f990be2c04a112021-12-02T00:11:02ZSleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives1179-1608https://doaj.org/article/1f5fece1b7434f5e994f990be2c04a112019-08-01T00:00:00Zhttps://www.dovepress.com/sleep-disturbances-in-patients-with-amyotrophic-lateral-sclerosis-curr-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Matthias BoentertDepartment of Neurology, University Hospital Muenster, Muenster, GermanyAbstract: Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease inevitably leading to generalized muscle weakness and premature death. Sleep disturbances are extremely common in patients with ALS and substantially add to the burden of disease for both patients and caregivers. Disruption of sleep can be caused by physical symptoms, such as muscle cramps, pain, reduced mobility, spasticity, mucus retention, and restless legs syndrome. In addition, depression and anxiety may lead to significant insomnia. In a small subset of patients, rapid eye movement (REM) sleep behavioral disorder may be present, reflecting neurodegeneration of central nervous system pathways which are involved in REM sleep regulation. With regard to overall prognosis, sleep-disordered breathing (SDB) and nocturnal hypoventilation (NH) are of utmost importance, particularly because NH precedes respiratory failure. Timely mechanical ventilation is one of the most significant therapeutic measures to prolong life span in ALS, and transcutaneous capnometry is superior to pulse oxymetry to detect NH early. In addition, it has been shown that in patients on home ventilatory support, survival time depends on whether normocapnia, normoxia, and elimination of apneic events during sleep can be reliably achieved. Several studies have investigated sleep patterns and clinical determinants of sleep disruption in ALS, but exact prevalence numbers are unknown. Thus, constant awareness for sleep-related symptoms is appropriate. Since no curative treatment can be offered to affected patients, sleep complaints should be thoroughly investigated in order to identify any treatable etiology and improve or stabilize quality of life as much as possible. The use of hypnotics should be confined to palliation during the terminal phase and refractory insomnia in earlier stages of the disease, taking into account that most compounds potentially aggravate SDB.Keywords: amyotrophic lateral sclerosis, sleep disorders, sleep-disordered breathing, non-invasive ventilation, health-related quality of lifeBoentert MDove Medical Pressarticleamyotrophic lateral sclerosissleep disorderssleep-disordered breathingnon-invasive ventilationhealth-related quality of lifePsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 11, Pp 97-111 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	amyotrophic lateral sclerosis sleep disorders sleep-disordered breathing non-invasive ventilation health-related quality of life Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	amyotrophic lateral sclerosis sleep disorders sleep-disordered breathing non-invasive ventilation health-related quality of life Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Boentert M Sleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives
description	Matthias BoentertDepartment of Neurology, University Hospital Muenster, Muenster, GermanyAbstract: Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease inevitably leading to generalized muscle weakness and premature death. Sleep disturbances are extremely common in patients with ALS and substantially add to the burden of disease for both patients and caregivers. Disruption of sleep can be caused by physical symptoms, such as muscle cramps, pain, reduced mobility, spasticity, mucus retention, and restless legs syndrome. In addition, depression and anxiety may lead to significant insomnia. In a small subset of patients, rapid eye movement (REM) sleep behavioral disorder may be present, reflecting neurodegeneration of central nervous system pathways which are involved in REM sleep regulation. With regard to overall prognosis, sleep-disordered breathing (SDB) and nocturnal hypoventilation (NH) are of utmost importance, particularly because NH precedes respiratory failure. Timely mechanical ventilation is one of the most significant therapeutic measures to prolong life span in ALS, and transcutaneous capnometry is superior to pulse oxymetry to detect NH early. In addition, it has been shown that in patients on home ventilatory support, survival time depends on whether normocapnia, normoxia, and elimination of apneic events during sleep can be reliably achieved. Several studies have investigated sleep patterns and clinical determinants of sleep disruption in ALS, but exact prevalence numbers are unknown. Thus, constant awareness for sleep-related symptoms is appropriate. Since no curative treatment can be offered to affected patients, sleep complaints should be thoroughly investigated in order to identify any treatable etiology and improve or stabilize quality of life as much as possible. The use of hypnotics should be confined to palliation during the terminal phase and refractory insomnia in earlier stages of the disease, taking into account that most compounds potentially aggravate SDB.Keywords: amyotrophic lateral sclerosis, sleep disorders, sleep-disordered breathing, non-invasive ventilation, health-related quality of life
format	article
author	Boentert M
author_facet	Boentert M
author_sort	Boentert M
title	Sleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives
title_short	Sleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives
title_full	Sleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives
title_fullStr	Sleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives
title_full_unstemmed	Sleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives
title_sort	sleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/1f5fece1b7434f5e994f990be2c04a11
work_keys_str_mv	AT boentertm sleepdisturbancesinpatientswithamyotrophiclateralsclerosiscurrentperspectives
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Sleep disturbances in patients with amyotrophic lateral sclerosis: current perspectives

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