Cochen De Cock Valérie
Pôle sommeil et neurologie, Clinique Beau Soleil, 119 avenue de Lodève, 34070, Montpellier, France.
EuroMov, University of Montpellier, 700 Avenue du Pic Saint Loup, 34090, Montpellier, France.
Curr Treat Options Neurol. 2018 Apr 20;20(6):16. doi: 10.1007/s11940-018-0503-8.
The purpose of this review was to explore the different sleep disorders associated with MSA, their mechanisms, and their treatments.
Stridor is a red flag for the diagnosis of MSA. Recent findings show that its presence in early stage of the disease is associated with a reduction in life expectancy. Its management should be fast and adapted. Its treatment with continuous positive airway pressure or tracheostomy is efficacious. Sleep disorders in MSA are frequent and severe combining insomnia, daytime sleepiness, restless legs syndrome (RLS), REM sleep behavior disorder (RBD), and sleep disordered breathing (SDB). Sleep recordings confirm these disorders. Mechanisms involved in these disorders are complex associating (a) lesions of the pathways regulating sleep and wake or mood but also controlling movement, (b) iatrogenic effects of the treatments, and (3) consequences of the motor or dysautonomic symptoms. RBD prevalence is very high at the beginning of the motor symptoms but then seems to disappear.
本综述旨在探讨与多系统萎缩（MSA）相关的不同睡眠障碍、其机制及治疗方法。
喘鸣是MSA诊断的一个警示信号。最新研究结果表明，其在疾病早期出现与预期寿命缩短有关。对此应迅速采取适当处理措施。持续气道正压通气或气管切开术治疗有效。MSA患者睡眠障碍常见且严重，包括失眠、日间嗜睡、不宁腿综合征（RLS）、快速眼动睡眠行为障碍（RBD）和睡眠呼吸障碍（SDB）。睡眠记录证实了这些障碍。这些障碍涉及的机制复杂，包括（a）调节睡眠与觉醒或情绪以及控制运动的通路受损，（b）治疗的医源性效应，以及（3）运动或自主神经功能障碍症状的后果。RBD在运动症状开始时患病率很高，但随后似乎消失。
