Study of sleep abnormalities in patients with NMOSD-MOG related disorders.

BACKGROUND

Sleep quality and architecture are rarely studied in Neuromyelitis Optica Spectrum disorder (NMOSD) and Myelin Oligodendrocyte associated disorder (MOGAD).

OBJECTIVES

To study sleep characteristics in patients with NMOSD and MOGAD.

METHODS

This prospective study (Total:72patients) was carried out in 27-Aquaporin-4positive-NMOSD (AQP4+NMO), 20-MOGAD and 25-dual seronegative NMOSD (SNNMOSD). We assessed sleep characteristics by questionnaires and nocturnal polysomnography in 10 clinically stable patients of each group and 20 healthy controls.

RESULTS

The Pittsburgh Sleep Quality Index (PSQI) (7.36±3.73,p = 0.02) and Berlin questionnaire were abnormal in SNNMOSD. Probable (RBD) (1.63±2.02,p = 0.026), anxiety (12.11±8.22,p = 0.047) and depression (9.7 ± 7.58,p = 0.009) scores were predominantly abnormal in AQP4+NMO patients. There was a positive correlation of physical disability with poor sleep quality (r = 0.29,p = 0.01), anxiety (r = 0.28,p = 0.02), depression (r = 0.24,p = 0.046) and development of RLS (r = 0.24,p = 0.04). Periodic limb movements were seen predominantly in SNNMOSD. Supratentorial lesions had higher stage-1 (N1) duration and reduced stage-2 (N2), stage-3 (N3), and REM duration. Voxel-based morphometry revealed a reduction in thalamic volume in all patients compared to healthy controls.

CONCLUSIONS

Sleep quality and architecture are impaired in NMOSD and MOGAD with significantly reduced thalamic volume. Sleep patterns reflect the extent of damage in NMOSD and MOGAD and would have implications on the comprehensive care.