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Morning headache is accepted as part of clinical findings of obstructive sleep apnoea syndrome (OSAS). The prevalence of morning headache is at variable levels from 18% to 74% in patients with OSAS. However, there is controversy over the association of morning headache and OSAS. We studied morning headache prevalence and characteristics in 101 controls with apnoea-hypnoea index (AHI) < 5 and 462 OSAS patients with AHI > or = 5. Morning headache was reported by only nine (8.9%) subjects in a control group compared with 156 (33.6%) of OSAS patients (P < 0.01). Morning headache prevalence was significantly higher in severe and moderate OSAS groups. AHI was significantly higher in OSAS patients with morning headache compared with patients without morning headaches. Oxygen saturation nadir during rapid eye movement and non-rapid eye movement sleep as well as mean oxygen saturation value during total sleep time were also found to be significantly lower in morning headache group. However, none of the sleep parameters was found to be determinants of morning headache. Morning headache was more frequently reported by patients of female gender and with primary headache history. Morning headache was totally resolved in 90% of patients treated with nasal continuous positive airway pressure. The history of OSAS should be considered in the differential diagnosis of morning headache.

SUMMARYBehçetÕs disease, a systemic vasculitis, can cause varying degrees of activity limitation, fatigue and quality of life impairment. To date, there have been no studies regarding sleep disturbance and its relationship with fatigue and life quality in BehçetÕs disease. We aimed to evaluate sleep disorders and polysomnographic parameters, and to determine their relationship with fatigue and quality of life in BehçetÕs disease. Fiftyone patients with BehçetÕs disease without any neurological involvement were interviewed regarding sleep disorders. Twenty-one subjects with no sleep complaints were included as the control group. Sleep-related complaints were evaluated in a face-to-face interview. Sleep quality, excessive daytime sleepiness, fatigue, depression, anxiety, disease activity ⁄ severity, and quality of life questionnaires and an overnight polysomnography were performed. Prevalences of restless legs syndrome (35.3%) and obstructive sleep apnea syndrome with ⁄ without other sleep disorders (32.5%) were higher than in the control group and the general population. Fatigue was higher in patients with restless legs syndrome and obstructive sleep apnea syndrome, and in those with lower minimum oxygen saturation; hence, only patients with restless legs syndrome had quality of life impairment. Sleep efficiency index and sleep continuity index were lower, and wake after sleep onset, respiratory disturbance index and apnea-hypopnea index were higher than in controls (P < 0.01). Neither sleep disorders nor polysomnographic parameters were related to disease activity and severity. In conclusion, it is important to question sleep disorder followed by a polysomnography, if necessary, in order to improve quality of life and fatigue in BehçetÕs disease. INTRODUC TIONBehçetÕs disease (BD) was first described by Turkish dermatologist Hulusi Behçet in 1937 as a triad of recurrent oral aphthae, genital ulcerations and relapsing uveitis (Behçet, 1937). BD is a chronic, systemic vasculitis with an unknown etiology, which can affect blood vessels (mainly veins) of all sizes. The clinical picture of BD is widely variable. In addition to the mucocutaneous lesions, ocular, vascular, articular, gastrointestinal, urogenital, pulmonary and neurological involvements have been seen during its course, and are characterized by a heterogeneous severity. BD progresses with unpredictable flares alternating with remission periods (Harzallah et al., 2008).The complexity of signs and symptoms in BD can disturb an individualÕs lifestyle by causing limitation in activity. As a result, numerous psychological problems may arise. Furthermore, it was shown in some studies that in patients with BD with fatigue, there was a significant association with impaired quality of life (QoL;Bodur et al., 2006). It was reported that

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are prone to error. Importantly, the study performed by Gerbin recommended a combination of sleep diaries and polysomnography be used in future studies to investigate sleep problems in patients with ET. 6 The aim of our study was to evaluate sleep disturbances and sleep-related events in patients with ET, PD, and controls, using both self-assessment tools and polysomnographic readings. METHODS Study SampleThe ethics committee of Bülent Ecevit University approved this prospective study, and informed consent was obtained from all participants. Between 2010 and 2012, 21 patients with PD who fulfi lled the Parkinson Disease Society Bank criteria, 9 and 16 patients with ET who fulfi lled Movement Disorders BRIEF SUMMARY Current Knowledge/Study Rationale: Sleep problems in ET and PD patients had been investigated in few studies by using subjective assessment tools like self-report questionnaires previously. This study was conducted to evaluate and to compare sleep problems in these two common movement disorders by using PSG which is an objective assessment tool. Study Impact: This study will improve the knowledge about sleep problems in ET and PD patients. Furthermore this is the fi rst study comparing sleep problems in ET and PD patients using PSG.Objective: Sleep problems are a common non-motor complication of Parkinson disease (PD), and patients with essential tremor (ET) share a number of motor and non-motor features of PD. To clarify the relationship between these disorders, we evaluated the sleep problems in patients with ET and PD using assessment scales and objective polysomnographic (PSG) testing. Method: Twenty-one consecutive patients with PD, 16 with ET, and 14 healthy subjects participated in this study and were compared in terms of sleep related complaints, fi nal sleep related diagnosis, and polysomnographic features. Results:The results of our study have shown that patients with PD were more likely than were those with ET to have a history of REM sleep behavior disorders (RBD) (p = 0.001) and excessive daytime sleepiness (p ≤ 0.05). Additionally, PSG data revealed that ET patients had lower mean SpO 2 values (p ≤ 0.05) and REM without atonia (RWA) (p = 0.032) than did patients with PD. Conclusion: This is the fi rst study to use PSG to evaluate sleep problems both in ET and PD patients. The results point out different sleep problems in these two common movement disorders which should be investigated in further studies. Keywords: essential tremor, Parkinson disease, sleep, REM behavior disorder (RBD), REM without atonia (RWA) Citation: Barut BO, Tascilar N, Varo A. Sleep disturbances in essential tremor and Parkinson disease: a polysomnographic study.