TY - JOUR
T1 - Sleep disruption in systemic sclerosis (scleroderma) patients
T2 - Clinical and polysomnographic findings
AU - Prado, Gilmar F.
AU - Allen, Richard P.
AU - Trevisani, Virgínia M.F.
AU - Toscano, Vanessa G.
AU - Earley, Christopher J.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - Background: Progressive systemic sclerosis (SSc) is a connective tissue disease characterized by endothelial lesions and fibrosis of the skin and other organs. Patients' quality of life and life expectancy are determined by the intensity of pulmonary, esophageal, cardiac, and renal involvement. Neurological involvement was considered to be rare, but increasing evidence indicates that peripheral and autonomic neuropathies commonly occur. Conditions seen with SSc, such as pulmonary fibrosis and gastro-esophageal reflux, have the potential to affect sleep. No systematic assessment of sleep-related problems associated with this disorder has been performed. Material and methods: An all-night polysomnogram and a clinical interview blinded to sleep status were obtained for 27 consecutive SSc patients. Sleep data were compared to age adjusted published normative values. Correlations were determined for sleep and clinical data. Results: Patients with SSc had a reduced sleep efficiency (SE) (mean ± SD: 82 ± 12.3%) and rapid eye movement sleep (13.1 ± 5.6%) and increased arousal index (26.1 ± 13.0) and slow wave sleep (25.7 ± 9.7%). The periodic leg movement index (PLMI) exceeded 5/h in 13 patients (48%) and 25/h in seven patients. Six patients had restless legs syndrome (RLS). Significant disordered breathing was absent. The RLS patients showed a greater arousal index than all other patients. PLMI was correlated with SE for RLS but not for non-RLS patients. Esophageal dyskinesia, dyspnea, and RLS were significantly associated with poor sleep. Conclusion: Patients with SSc have significant disturbance of their sleep. Esophageal dyskinesia and dyspnea, which are common complications of SSc, were commonly associated with indices of sleep disruption. RLS but not sleep apnea appears to have an increased prevalence in SSc.
AB - Background: Progressive systemic sclerosis (SSc) is a connective tissue disease characterized by endothelial lesions and fibrosis of the skin and other organs. Patients' quality of life and life expectancy are determined by the intensity of pulmonary, esophageal, cardiac, and renal involvement. Neurological involvement was considered to be rare, but increasing evidence indicates that peripheral and autonomic neuropathies commonly occur. Conditions seen with SSc, such as pulmonary fibrosis and gastro-esophageal reflux, have the potential to affect sleep. No systematic assessment of sleep-related problems associated with this disorder has been performed. Material and methods: An all-night polysomnogram and a clinical interview blinded to sleep status were obtained for 27 consecutive SSc patients. Sleep data were compared to age adjusted published normative values. Correlations were determined for sleep and clinical data. Results: Patients with SSc had a reduced sleep efficiency (SE) (mean ± SD: 82 ± 12.3%) and rapid eye movement sleep (13.1 ± 5.6%) and increased arousal index (26.1 ± 13.0) and slow wave sleep (25.7 ± 9.7%). The periodic leg movement index (PLMI) exceeded 5/h in 13 patients (48%) and 25/h in seven patients. Six patients had restless legs syndrome (RLS). Significant disordered breathing was absent. The RLS patients showed a greater arousal index than all other patients. PLMI was correlated with SE for RLS but not for non-RLS patients. Esophageal dyskinesia, dyspnea, and RLS were significantly associated with poor sleep. Conclusion: Patients with SSc have significant disturbance of their sleep. Esophageal dyskinesia and dyspnea, which are common complications of SSc, were commonly associated with indices of sleep disruption. RLS but not sleep apnea appears to have an increased prevalence in SSc.
KW - Esophageal dyskinesia and sleep apnea
KW - Periodic leg movement of sleep
KW - Polysomnography
KW - Restless leg syndrome
KW - Sleep disorder
KW - Systemic sclerosis
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U2 - 10.1016/S1389-9457(02)00013-8
DO - 10.1016/S1389-9457(02)00013-8
M3 - Article
C2 - 14592197
AN - SCOPUS:0036045239
SN - 1389-9457
VL - 3
SP - 341
EP - 345
JO - Sleep Medicine
JF - Sleep Medicine
IS - 4
ER -