Sleep Medicine Center, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy.
Sleep Medicine Center, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
Sleep Med. 2021 Dec;88:134-139. doi: 10.1016/j.sleep.2021.10.003. Epub 2021 Oct 15.
The present study aimed at identifying the sleep-wake rhythm in patients with myotonic dystrophy type 1 (DM1) compared to healthy controls.
Patients with genetic diagnosis of DM1 and healthy controls underwent a 7-day actigraphic recording and filled out a daily sleep diary to evaluate the sleep-wake rhythm. All participants underwent a physical and neurological examination to exclude conditions interfering with the sleep-wake cycle. Daytime activity, nocturnal sleep, and non-parametric circadian rhythm activity (NPCRA) were analysed.
Twenty-nine patients affected by DM1 were included in the present study and were compared to 16 controls. Considering nocturnal actigraphic data, DM1 patients showed a longer time in bed, sleep period time, actual sleep time, and sleep latency compared to controls. Central phase measurement was significantly longer in DM1 patients than controls. At NPCRA analysis patients showed a lower degree of regularity in the activity-rest pattern compared to controls. Moreover, DM1 patients showed reduced motor activity during daytime and a lower synchronization of the rest-activity rhythm than controls.
This study documented that patients with DM1 not only present the impairment of nocturnal sleep, but also show a dysregulation of the sleep-wake circadian rhythm; moreover, reduced amplitude of the circadian rhythmicity was also evident in comparison to controls, probably in relation to the reduced diurnal motor activity of patients. These findings add further evidence to the already documented sleep impairment and excessive daytime sleepiness in DM1 patients.
本研究旨在比较 1 型肌强直性营养不良（DM1）患者与健康对照组之间的睡眠-觉醒节律。
经基因诊断为 DM1 的患者和健康对照者进行了 7 天的活动记录仪记录，并填写了每日睡眠日记，以评估睡眠-觉醒节律。所有参与者均接受了身体和神经系统检查，以排除影响睡眠-觉醒周期的疾病。分析了日间活动、夜间睡眠和非参数昼夜节律活动（NPCRA）。
本研究纳入了 29 例 DM1 患者，并与 16 例对照组进行了比较。考虑到夜间活动记录仪数据，DM1 患者的卧床时间、睡眠周期时间、实际睡眠时间和睡眠潜伏期均长于对照组。DM1 患者的中央相位测量明显长于对照组。在 NPCRA 分析中，与对照组相比，患者的活动-休息模式的规律性较低。此外，与对照组相比，DM1 患者白天的运动活动减少，休息-活动节律的同步性降低。
本研究记录了 DM1 患者不仅存在夜间睡眠障碍，而且还存在睡眠-觉醒昼夜节律失调；此外，与对照组相比，患者的昼夜节律性振幅也降低，这可能与患者白天的运动活动减少有关。这些发现进一步证明了 DM1 患者已经存在的睡眠障碍和日间过度嗜睡。
