Sleep patterns associated with the severity of impairment in a large cohort of patients with chronic disorders of consciousness

Research output: Contribution to journalArticle

Abstract

Objective: We assessed sleep patterns in 85 patients with chronic disorders of consciousness (DOC) in order to reveal any relationship with the degree of the impairment. Methods: Nocturnal polysomnography (PSG) was scored in patients classified as being in an unresponsive wakefulness syndrome/vegetative state (UWS/VS; n = 49) or a minimally conscious state (MCS; n = 36) in accordance with the rules of the American Academy of Sleep Medicine. The PSG data in the two diagnostic groups were compared, and the PSG parameters associated with the degree of impairment were analysed. Results: In 19/49 UWS/VS patients, signal attenuation was the only EEG pattern detectable in sleep. Non-REM 2 (NREM2) and slow-wave sleep (SWS) (but not REM) stages were more frequent in the MCS patients. The presence of SWS was the most appropriate factor for classifying patients as UWS/VS or MCS, and the duration of SWS was the main factor that significantly correlated with revised Coma Recovery Scale scores. Conclusion: The presence of NREM sleep (namely SWS) reflects better preservation of the circuitry and structures needed to sustain this stage of sleep in DOC patients. Significance: PSG is a simple and effective technique, and sleep patterns may reflect the degree of impairment in chronic DOC patients.

Original languageEnglish
Pages (from-to)687-693
Number of pages7
JournalClinical Neurophysiology
Volume129
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

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Consciousness Disorders
Sleep
Polysomnography
Persistent Vegetative State
Wakefulness
Coma
Consciousness
Electroencephalography
Medicine

Keywords

  • Minimally conscious state
  • Polysomnography
  • Sleep
  • Unresponsive wakefulness syndrome
  • Vegetative state

ASJC Scopus subject areas

  • Sensory Systems
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

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title = "Sleep patterns associated with the severity of impairment in a large cohort of patients with chronic disorders of consciousness",
abstract = "Objective: We assessed sleep patterns in 85 patients with chronic disorders of consciousness (DOC) in order to reveal any relationship with the degree of the impairment. Methods: Nocturnal polysomnography (PSG) was scored in patients classified as being in an unresponsive wakefulness syndrome/vegetative state (UWS/VS; n = 49) or a minimally conscious state (MCS; n = 36) in accordance with the rules of the American Academy of Sleep Medicine. The PSG data in the two diagnostic groups were compared, and the PSG parameters associated with the degree of impairment were analysed. Results: In 19/49 UWS/VS patients, signal attenuation was the only EEG pattern detectable in sleep. Non-REM 2 (NREM2) and slow-wave sleep (SWS) (but not REM) stages were more frequent in the MCS patients. The presence of SWS was the most appropriate factor for classifying patients as UWS/VS or MCS, and the duration of SWS was the main factor that significantly correlated with revised Coma Recovery Scale scores. Conclusion: The presence of NREM sleep (namely SWS) reflects better preservation of the circuitry and structures needed to sustain this stage of sleep in DOC patients. Significance: PSG is a simple and effective technique, and sleep patterns may reflect the degree of impairment in chronic DOC patients.",
keywords = "Minimally conscious state, Polysomnography, Sleep, Unresponsive wakefulness syndrome, Vegetative state",
author = "{Rossi Sebastiano}, Davide and Elisa Visani and Ferruccio Panzica and Davide Sattin and Anna Bersano and Anna Nigri and Stefania Ferraro and Eugenio Parati and Matilde Leonardi and Silvana Franceschetti",
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T1 - Sleep patterns associated with the severity of impairment in a large cohort of patients with chronic disorders of consciousness

AU - Rossi Sebastiano, Davide

AU - Visani, Elisa

AU - Panzica, Ferruccio

AU - Sattin, Davide

AU - Bersano, Anna

AU - Nigri, Anna

AU - Ferraro, Stefania

AU - Parati, Eugenio

AU - Leonardi, Matilde

AU - Franceschetti, Silvana

PY - 2018/3/1

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N2 - Objective: We assessed sleep patterns in 85 patients with chronic disorders of consciousness (DOC) in order to reveal any relationship with the degree of the impairment. Methods: Nocturnal polysomnography (PSG) was scored in patients classified as being in an unresponsive wakefulness syndrome/vegetative state (UWS/VS; n = 49) or a minimally conscious state (MCS; n = 36) in accordance with the rules of the American Academy of Sleep Medicine. The PSG data in the two diagnostic groups were compared, and the PSG parameters associated with the degree of impairment were analysed. Results: In 19/49 UWS/VS patients, signal attenuation was the only EEG pattern detectable in sleep. Non-REM 2 (NREM2) and slow-wave sleep (SWS) (but not REM) stages were more frequent in the MCS patients. The presence of SWS was the most appropriate factor for classifying patients as UWS/VS or MCS, and the duration of SWS was the main factor that significantly correlated with revised Coma Recovery Scale scores. Conclusion: The presence of NREM sleep (namely SWS) reflects better preservation of the circuitry and structures needed to sustain this stage of sleep in DOC patients. Significance: PSG is a simple and effective technique, and sleep patterns may reflect the degree of impairment in chronic DOC patients.

AB - Objective: We assessed sleep patterns in 85 patients with chronic disorders of consciousness (DOC) in order to reveal any relationship with the degree of the impairment. Methods: Nocturnal polysomnography (PSG) was scored in patients classified as being in an unresponsive wakefulness syndrome/vegetative state (UWS/VS; n = 49) or a minimally conscious state (MCS; n = 36) in accordance with the rules of the American Academy of Sleep Medicine. The PSG data in the two diagnostic groups were compared, and the PSG parameters associated with the degree of impairment were analysed. Results: In 19/49 UWS/VS patients, signal attenuation was the only EEG pattern detectable in sleep. Non-REM 2 (NREM2) and slow-wave sleep (SWS) (but not REM) stages were more frequent in the MCS patients. The presence of SWS was the most appropriate factor for classifying patients as UWS/VS or MCS, and the duration of SWS was the main factor that significantly correlated with revised Coma Recovery Scale scores. Conclusion: The presence of NREM sleep (namely SWS) reflects better preservation of the circuitry and structures needed to sustain this stage of sleep in DOC patients. Significance: PSG is a simple and effective technique, and sleep patterns may reflect the degree of impairment in chronic DOC patients.

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