Clinical and polysomnographic features of patients with multiple system atrophy in Southwest China

Sleep Breath. 2013 Dec;17(4):1301-7. doi: 10.1007/s11325-013-0839-y. Epub 2013 Apr 6.

Abstract

Purpose: The association between clinical features and polysomnographic variables of Chinese patients with multiple-system atrophy (MSA) remains largely unknown.

Methods: This study assessed 30 patients with MSA from Southwest China using the Unified Multiple-System Atrophy Rating Scale (UMSARS). Each patient also underwent video-polysomnography. Twenty age and gender matched healthy volunteers were performed video-polysomnography as control group.

Results: Of the 30 patients, 23 (76.7 %) were classified as having MSA-C and seven (23.3 %) were diagnosed with MSA-P. The mean age of the patients at disease onset was 53.2 ± 8.5 years, and the mean duration of their disease was 3.6 ± 2.8 years. Twenty-one patients complained of sleep disorders. The mean scores of UMSARS-I, UMSARS-II, and UMSARS-IV of patients with MSA-P were significantly higher than those of patients with MSA-C. Polysomnography revealed that 29 patients had sleep architecture alteration. A longer duration of stage N1 sleep, a shorter REM sleep, as well as decreased sleep efficiency and total sleep time (TST) were detected. Twenty-one patients had obstructive sleep apnea. Patients with MSA-C demonstrated longer sleep onset latencies compared with patients with MSA-P. TST was negatively correlated with MSA duration, whereas sleep latency was positively correlated with MSA duration. Moreover, TST, and mean SaO2 were negatively correlated with motor disability.

Conclusions: Various sleep disorders are common in Chinese MSA patients. Sleep architecture and sleep-associated breathing disorders are predominant polysomnographic findings. Sleep quantity was reduced with disease progression.

MeSH terms

  • Adult
  • Aged
  • China
  • Comorbidity
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple System Atrophy / diagnosis*
  • Multiple System Atrophy / epidemiology*
  • Neurologic Examination
  • Polysomnography*
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / epidemiology*