Even among individuals who are clinically stable, sleep disturbances are a common complication in patients with myasthenia gravis (MG), highlighting the need for a comprehensive approach to tackle this issue, according to a study recently published in Neurología.
The symptoms of MG — mainly muscle fatigability and weakness — often drive sleep disturbances. If patients have comorbidities that impact sleep quality (such as obstructive sleep apnea), sleep may be even worse. Yet sleep disturbances associated with MG are relatively unexplored in the research.
Researchers sought to better understand sleep disturbances among patients who have clinically stable MG. They recruited clinically stable patients from three specialized MG centers in China between August and November 2023. In total, 208 patients with sleep disturbances (i.e., patients with a Pittsburgh Sleep Quality Index [PSQI] ≥6) and 98 who did not have sleep problems (PSQI <6) were surveyed.
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The researchers found a number of factors that were statically powerful enough to be strongly correlated to the PSQI score. Specifically, researchers reported that sex, martial status and three clinical scores — the STOP-Bang (for obstructive sleep apnea), the standardized age score, and the MG Quality of Life 15 — were found to be closely related to PSQI scores. These factors had a strong correlation with sleep disorder severity, and likely hurt sleep.
In addition, a number of factors were associated with a higher likelihood of sleep dysfunction. For example, patients with generalized MG were more likely to have a poorer quality of sleep compared with those who had ocular MG. Other risk factors for a poorer quality of sleep include a late disease onset, a history of thymectomy and myasthenic crisis. Anxiety and depression were particularly prevalent among patients who suffered from sleep dysfunction.
The authors noted that these results highlight the need to recognize and address sleep disturbances in people with MG. “Sleep disturbances are frequently encountered in patients with MG, particularly among those with stable symptoms,” the study’s authors wrote. “Our findings underscore the importance of addressing psychological factors, such as anxiety, and assessing health-related quality of life in clinically stable patients.”
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