Depression as the Primary Cause of Insomnia and Excessive Daytime Sleepiness in a Family with Multiple Cases of Spinocerebellar Ataxia

Hsu, Chun-Hsien; Chen, Yen‐Lin; Pei, Dee; Yu, Shu-Man; Liu, I-Chao

doi:10.5664/jcsm.5950

Cited by 6 publications

(1 citation statement)

References 5 publications

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“…In atypical Parkinson syndromes, such as Multisystem atrophy (MSA), the reported incidence of insomnia is about 70% compared to 62% in PD and also in Progressive supranuclear palsy (PSP) insomnia and disturbed sleep architecture occurred more frequently than in PD (Abbott 2014, [41]). Also, 37,7% of patients with SCA type 3 suffer from insomnia [42], while a case series of patients from one family with SCA type 2 showed a strong association between insomnia and depression [43].…”

Section: Insomnia In Neurodegenerative Movement Disordersmentioning

confidence: 99%

Insomnia in neurological diseases

Mayer

Happe²,

Evers

et al. 2021

Neurol. Res. Pract.

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Insomnia is defined as difficulties of initiating and maintaining sleep, early awakening and poor subjective sleep quality despite adequate opportunity and circumstances for sleep with impairment of daytime performance. These components of insomnia – namely persistent sleep difficulties despite of adequate sleep opportunity resulting in daytime dysfunction - appear secondary or co-morbid to neurological diseases. Comorbid insomnia originates from neurodegenerative, inflammatory, traumatic or ischemic changes in sleep regulating brainstem and hypothalamic nuclei with consecutive changes of neurotransmitters. Symptoms of neurological disorders (i.e motor deficits), co-morbidities (i.e. pain, depression, anxiety) and some disease-specific pharmaceuticals may cause insomnia and/or other sleep problems.This guideline focuses on insomnias in headaches, neurodegenerative movement disorders, multiple sclerosis, traumatic brain injury, epilepsies, stroke, neuromuscular disease and dementia.The most important new recommendations are: Cognitive behavioral therapy (CBTi) is recommended to treat acute and chronic insomnia in headache patients. Insomnia is one of the most frequent sleep complaints in neurodegenerative movement disorders. Patients may benefit from CBTi, antidepressants (trazodone, doxepin), melatonin and gaba-agonists. Insomnia is a frequent precursor of MS symptoms by up to 10 years. CBTi is recommended in patients with MS, traumatic brain injury and. Melatonin may improve insomnia symptoms in children with epilepsies. Patients with insomnia after stroke can be treated with benzodiazepine receptor agonists and sedating antidepressants. For patients with dementia suffering from insomnia trazodone, light therapy and physical exercise are recommended.

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Section: Insomnia In Neurodegenerative Movement Disordersmentioning

confidence: 99%

Insomnia in neurological diseases

Mayer

Happe²,

Evers

et al. 2021

Neurol. Res. Pract.

View full text Add to dashboard Cite

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Sleep Disorders in Hereditary Ataxias

Huebra

Coelho

Filho

et al. 2019

Curr Neurol Neurosci Rep

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Factors Influencing Health-Related Quality of Life of Patients with Spinocerebellar Ataxia

Weber,

Buchholz,

Rädke

et al. 2024

Cerebellum

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Background Little is known about the progression of health-related quality of life (HRQoL) and predicting factors in spinocerebellar ataxia (SCA). Such knowledge is crucial to identify modifiable factors promoting everyday life with SCA and attenuating HRQoL decline. Objectives This study is to assess HRQoL progression and identify factors affecting SCA patients’ HRQoL. Methods Longitudinal data (three-year follow-up) of 310 SCA patients of the European SCA3/Machado-Joseph-Disease Initiative (ESMI) (2016-2022) and 525 SCA patients (SCA1, SCA2, SCA3 or SCA6) of the EUROSCA natural history study cohort (2006–2015) were assessed. Both large cohort studies share standardized assessments of clinical measures, SARA, INAS, PHQ-9, and HRQoL (EQ-5D-3L). The association between HRQoL and clinical measures was assessed by Spearman Correlation (rs). Multivariable panel regression models were performed to evaluate the impact of patients’ socio-demographics, age of onset, SCA type and body mass index (BMI), and clinical measures on HRQoL progression. Results HRQoL significantly decreased over one (− 0.014, p = 0.095), two (− 0.028, p = 0.003), and three years (− 0.032, p = 0.002). Ataxia severity and mental health strongly correlated with HRQoL (rsSARA = − 0.589; rsPHQ-9 = − 0.507). HRQoL more intensively declined in male (ß = − 0.024, p = 0.038) patients with an earlier age of onset (ß = 0.002, p = 0.058). Higher progression of ataxia severity (ß = − 0.010, p ≤ 0.001), mental health problems (ß = − 0.012, p < 0.001), and higher BMI (ß = − 0.003, p = 0.029) caused more severe decline of patients’ HRQoL over time. Discussion In absence of curative treatments, stronger focus on mental health and weight influence could help clinical evaluation and accompany treatment improving SCA patients’ HRQoL, especially in male patients with early disease onset.

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Depression as the Primary Cause of Insomnia and Excessive Daytime Sleepiness in a Family with Multiple Cases of Spinocerebellar Ataxia

Cited by 6 publications

References 5 publications

Insomnia in neurological diseases

Insomnia in neurological diseases

Sleep Disorders in Hereditary Ataxias

Factors Influencing Health-Related Quality of Life of Patients with Spinocerebellar Ataxia

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