Fragmentation of slow wave sleep after onset of complete locked-in state

Surjo R. Soekadar, Jan Born, Niels Birbaumer, Michael Bensch, Sebastian Halder, Ander Ramos Murguialday, Alireza Gharabaghi, Femke Nijboer, Bernhard Schol̈kopf, Suzanne Martens

Research output: Contribution to journalArticlepeer-review


Locked-in syndrome (LIS) as a result of brainstem lesions or progressive neurodegenerative disorders, such as amyotrophic lateral sclerosis (ALS), is a severe medical condition in which a person is fully conscious but unable to move or talk. LIS can transition into complete locked-in syndrome (CLIS) in which residual abilities to communicate through muscle twitches are entirely lost. It is unknown how CLIS affects circadian rhythm and sleep/wake patterns. Here we report a 39-year-old ALS patient who transitioned from LIS to CLIS while brain activity was continuously recorded using electrocorticography (ECoG) over one month. While we found no circadian rhythm in heart rate and body temperature, transition into CLIS was associated with increased fragmentation of slow wave sleep (SWS) across the day. Total time in SWS did not change. SWS fragmentation might refl ect progressive circadian system impairment and should be considered as a factor further limiting communication capabilities in these patients.

Original languageEnglish
Pages (from-to)951-953
Number of pages3
JournalJournal of Clinical Sleep Medicine
Issue number9
Publication statusPublished - 2013


  • Circadian rhythm
  • Communication
  • Complete locked-in syndrome
  • Sleep fragmentation

ASJC Scopus subject areas

  • Clinical Neurology
  • Pulmonary and Respiratory Medicine
  • Neurology


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