Herzog-Krzywoszanska Radoslawa, Krzywoszanski Lukasz
General Psychology Unit, Chair of Psychology, Faculty of Pedagogy, Pedagogical University of Krakow, Krakow, Poland.
Neurocognitive Psychology Unit, Chair of Psychology, Faculty of Pedagogy, Pedagogical University of Krakow, Krakow, Poland.
Front Psychiatry. 2019 Apr 12;10:221. doi: 10.3389/fpsyt.2019.00221. eCollection 2019.
Huntington's chorea (Huntington's disease, HD) is a genetic disorder caused by autosomal dominant mutation, leading to progressive neurodegenerative changes in the central nervous system. Involuntary movements such as chorea occur typically in HD patients, accompanied by progressive cognitive and psychiatric disturbances. Other common symptoms of HD are circadian and sleep abnormalities, which are observed from the earliest stages of the disease or even before the occurrence of clinical symptoms. The most common sleep problems reported by HD patients include insomnia, difficulties in falling asleep, frequent nocturnal awakenings, and excessive daytime sleepiness. Also, specific changes in sleep architecture have been identified in HD. In this paper, we review studies on sleep and circadian rhythm disorders in HD. We outline findings concerning sleep patterns and disturbances of circadian rhythms in HD patients, as well as the role of psychiatric disorders and motor disorders in HD patients' sleep problems. We also discuss problems related to the different methods of diagnosing sleep disorders in HD. Furthermore, the adverse effects of medication used for the treatment of core HD symptoms as one of the sources of sleep disturbances in HD are emphasized. In conclusion, the diversity and complexity of the determinants of sleep and circadian rhythm disorders in HD are highlighted. Finally, the relevance of effective treatment to improve patients' functioning and quality of life as well as the potential relief of their cognitive and emotional symptoms is addressed.
亨廷顿舞蹈症（亨廷顿病，HD）是一种由常染色体显性突变引起的遗传性疾病，会导致中枢神经系统进行性神经退行性改变。舞蹈症等不自主运动通常出现在HD患者身上，同时伴有进行性认知和精神障碍。HD的其他常见症状是昼夜节律和睡眠异常，在疾病的最早阶段甚至在临床症状出现之前就可观察到。HD患者报告的最常见睡眠问题包括失眠、入睡困难、夜间频繁醒来和日间过度嗜睡。此外，HD患者的睡眠结构也有特定变化。在本文中，我们回顾了关于HD患者睡眠和昼夜节律紊乱的研究。我们概述了HD患者睡眠模式和昼夜节律紊乱的研究结果，以及精神障碍和运动障碍在HD患者睡眠问题中的作用。我们还讨论了HD患者睡眠障碍不同诊断方法相关的问题。此外，强调了用于治疗HD核心症状的药物作为HD患者睡眠障碍来源之一的不良反应。总之，突出了HD患者睡眠和昼夜节律紊乱决定因素的多样性和复杂性。最后，探讨了有效治疗对改善患者功能和生活质量以及缓解其认知和情绪症状的相关性。
