Category: Parkinsonism, Atypical: MSA
Objective: To investigate the prevalence and determinants of sleep-related symptoms in multiple system atrophy (MSA) and the impact of sleep disturbances on disease severity.
Background: Sleep-related symptoms is an unsolved issue for patients with multiple system atrophy (MSA).
Method: 165 MSA patients were enrolled in this cross-sectional study. Three sleep-related symptoms–PD-related sleep problems (PD-SP), excessive daytime sleepiness (EDS), and rapid eye movement behavior disorder (RBD)–were evaluated by PD Sleep Scale-2 (PDSS-2), Epworth Sleepiness Scale (ESS), and RBD Screening Questionnaire (RBDSQ) respectively. Disease severity was evaluated by unified multiple system atrophy rating scale (UMSARS). Binary logistic regression was used to analyze the determinants of the three sleep-related symptoms and stepwise regression model was used to analyze the impact of them on disease severity.
Results: The prevalence of PD-SP (PDSS-2≥18), EDS (ESS≥10), and RBD (RBDSQ≥5) in MSA was 18.8%, 27.3%, and 49.7% respectively. Binary logistic regression revealed that MSA-P subtype (OR 3.861 p=0.005), higher total UMSARS score (OR 1.042 p=0.022), and anxiety (OR 4.755 p=0.001) were determinants of PD-SP; male sex (OR 3.309 p=0.005), higher total UMSARS score (OR 1.036 p=0.032), MSA-P subtype (OR 2.733 p=0.012), and fatigue (OR 3.654 p=0.005) were determinants of EDS; male sex (OR 2.614 p=0.005), higher total UMSARS score (OR 1.052 p=0.001), and autonomic onset (OR 0.486 p=0.044) were determinants of RBD in MSA. Stepwise linear regression showed that disease duration, depression, fatigue, total Moca score, and the number of sleep-related symptoms (PD-SP, EDS and RBD) were predictors of disease severity in MSA.
Conclusion: MSA-P subtype, male sex, autonomic onset, anxiety, fatigue and higher total UMSARS score tended to be associated with sleep-related symptoms in MSA. An increased number of sleep-related symptoms had an impact on disease severity in MSA.
To cite this abstract in AMA style:J.Y Lin, L.Y Zhang, B. Cao, QQ. Wei, H.F Shang. Sleep-related Symptoms in Multiple System Atrophy: Determinants and Impact on disease severity [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/sleep-related-symptoms-in-multiple-system-atrophy-determinants-and-impact-on-disease-severity/. Accessed December 5, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-related-symptoms-in-multiple-system-atrophy-determinants-and-impact-on-disease-severity/