title: Quality of sleep in primary focal dystonia: a case-control study.
abstract: BACKGROUND
  Sleep disturbances are common in patients with movement disorders. Evaluating quality of sleep is of primary importance because of the effect that nocturnal and daytime sleep abnormalities exert on general health status. However, quality of sleep has never been addressed in detail in patients with dystonia. The aim of this case-control study was to analyse quality of sleep in patients with the two most common forms of primary focal dystonia, blepharospasm (BSP) and cervical dystonia (CD).
  
  
  METHODS
  We evaluated quality of sleep (Pittsburgh Sleep Quality Index, PSQI) and excessive daytime sleepiness (Epworth Sleepiness Scale, ESS) in 98 patients with focal adult-onset dystonia (52 with BSP; 46 with CD) and in a group of 56 age-and gender-matched healthy subjects. The Beck Depression Inventory (BDI) was used for the evaluation of depressive symptomatology.
  
  
  RESULTS
  Quality of sleep was impaired (significantly higher PSQI scores) in both groups of patients. However, differences in PSQI scores between patients with CD and control subjects were partly confounded by BDI scores, whereas differences in PSQI scores between patients with BSP and control subjects were not influenced by BDI. Excessive daytime sleepiness was not significantly more frequent than in control subjects in either patients with BSP or patients with CD.
  
  
  CONCLUSIONS
  This study suggests that the assessment and treatment of insomnia-related complaints should be considered in global management plans of patients with focal dystonia, particularly in those affected by BSP.
authors.affiliation: Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Avanzino
authors.forename: D
authors.initials: D
authors.lastname: Martino
authors.forename: R
authors.initials: R
authors.lastname: Marchese
authors.forename: M S
authors.initials: MS
authors.lastname: Aniello
authors.forename: B
authors.initials: B
authors.lastname: Minafra
authors.forename: M
authors.initials: M
authors.lastname: Superbo
authors.forename: G
authors.initials: G
authors.lastname: Defazio
authors.forename: G
authors.initials: G
authors.lastname: Abbruzzese
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001764:Blepharospasm / Q000150:complications* / Q000175:diagnosis; D016022:Case-Control Studies; D003863:Depression / Q000150:complications / Q000175:diagnosis; D020821:Dystonic Disorders / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014103:Torticollis / Q000150:complications* / Q000175:diagnosis