Journal des troubles du sommeil et de la thérapie
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Sleep Abnormalities in Guillain Barre Syndrome: A Clinical and Polysomnographic Study

Karkare K, Sinha S, Taly AB and Rao S

Purpose: We analyzed the polysomnographic (PSG) profile and various factors contributing to sleep disturbances in patients with GB Syndrome.

Methodology: This prospective hospital based study included 30 adults with GB syndrome (mean: 34.30 ± 1.40 years; M:F=24:6). All patients underwent evaluation with phenotypic details, nerve conduction studies, sleep questionnaires and over-night polysomnography (PSG). Three (10%) patients had baseline sleep disturbances with a Pittsburgh Sleep Quality Index (PSQI) of >5 and all the 3 patients continued to have poor sleep during hospitalization. Sixteen (53.3%) patients had poor sleep during their hospital stay as assessed by Richards score. Sleep disturbances as per St Mary’s sleep score depicted similar observations over 10 nights. Overnight PSG was carried out within 1st to 12 day of hospitalization (mean: 6.83 ± 3.07; median: 6.5).

Results: During overnight PSG several patients did not have all the stages of sleep: stage 1-2 patients, stage 3-6 patients, stage 4-13 patients and REM stage -7 patients. Other notable PSG observations were: increased stage 1 and stage 2 sleep, reduced stage 4 and REM sleep, decreased sleep efficiency of <85% -28; increased sleep onset latency of >30 min -4; duration of sleep of <6 hours -20; and increased arousal (arousals >5/hour) -6. Majority of arousals were due to respiratory events and oxygen desaturation. Three patients had abnormal periodic leg movement (PLM) arousal index (>5/hours). Sub-analysis revealed that depressed patients had lesser duration of sleep (p=0.049). There no REM related behavioral disorder noted.

Conclusions: To conclude, sleep disturbances and altered sleep architecture in GB syndrome during hospitalization are common and may be multifactorial.