title: Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study).
abstract: BACKGROUND
  Sleep disorders are common in multiple system atrophy (MSA), but the prevalence of excessive daytime sleepiness (EDS) is not well known.
  
  
  OBJECTIVE
  To assess the frequency and associations of EDS in MSA.
  
  
  METHODS
  Survey of EDS in consecutive patients with MSA and comparison with patients with Parkinson disease (PD) and individuals without known neurologic disease.
  
  
  METHODS
  Twelve tertiary referral centers.
  
  
  METHODS
  Eighty-six consecutive patients with MSA; 86 patients with PD matched for age, sex, and Hoehn and Yahr stage; and 86 healthy subject individuals matched for age and sex.
  
  
  METHODS
  Epworth Sleepiness Scale (ESS), modified ESS, Sudden Onset of Sleep Scale, Tandberg Sleepiness Scale, Pittsburgh Sleep Quality Index, disease severity, dopaminergic treatment amount, and presence of restless legs syndrome.
  
  
  RESULTS
  Mean (SD) ESS scores were comparable in MSA (7.72 [5.05]) and PD (8.23 [4.62]) but were higher than in healthy subjects (4.52 [2.98]) (P < .001). Excessive daytime sleepiness (ESS score >10) was present in 28% of patients with MSA, 29% of patients with PD, and 2% of healthy subjects (P < .001). In MSA, in contrast to PD, the amount of dopaminergic treatment was not correlated with EDS. Disease severity was weakly correlated with EDS in MSA and PD. Restless legs syndrome occurred in 28% of patients with MSA, 14% of patients with PD, and 7% of healthy subjects (P < .001). Multiple regression analysis (with 95% confidence intervals obtained using nonparametric bootstrapping) showed that sleep-disordered breathing and sleep efficiency predicted EDS in MSA and amount of dopaminergic treatment and presence of restless legs syndrome in PD.
  
  
  CONCLUSIONS
  More than one-quarter of patients with MSA experience EDS, a frequency similar to that encountered in PD. In these 2 conditions, EDS seems to be associated with different causes.
authors.affiliation: Movement Disorders Unit, Department of Neurology, Hospital Clinic of Barcelona, University of Barcelona Medical School and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, 08036 Barcelona, Spain.
authors.forename: Claudia
authors.initials: C
authors.lastname: Moreno-López
authors.forename: Joan
authors.initials: J
authors.lastname: Santamaría
authors.forename: Manuel
authors.initials: M
authors.lastname: Salamero
authors.forename: Francesca
authors.initials: F
authors.lastname: Del Sorbo
authors.forename: Alberto
authors.initials: A
authors.lastname: Albanese
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Pellecchia
authors.forename: Paolo
authors.initials: P
authors.lastname: Barone
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Overeem
authors.forename: Bastiaan
authors.initials: B
authors.lastname: Bloem
authors.forename: Willemijn
authors.initials: W
authors.lastname: Aarden
authors.forename: Margherita
authors.initials: M
authors.lastname: Canesi
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
authors.forename: Susanne
authors.initials: S
authors.lastname: Duerr
authors.forename: Gregor K
authors.initials: GK
authors.lastname: Wenning
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
authors.forename: Alfonso
authors.initials: A
authors.lastname: Rubino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Meco
authors.forename: Susanne A
authors.initials: SA
authors.lastname: Schneider
authors.forename: Kailash P
authors.initials: KP
authors.lastname: Bhatia
authors.forename: Ruth
authors.initials: R
authors.lastname: Djaldetti
authors.forename: Miguel
authors.initials: M
authors.lastname: Coelho
authors.forename: Cristina
authors.initials: C
authors.lastname: Sampaio
authors.forename: Valerie
authors.initials: V
authors.lastname: Cochen
authors.forename: Helge
authors.initials: H
authors.lastname: Hellriegel
authors.forename: Günther
authors.initials: G
authors.lastname: Deuschl
authors.forename: Carlo
authors.initials: C
authors.lastname: Colosimo
authors.forename: Luca
authors.initials: L
authors.lastname: Marsili
authors.forename: Thomas
authors.initials: T
authors.lastname: Gasser
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tolosa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015897:Comorbidity; D016001:Confidence Intervals; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis / Q000453:epidemiology*; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012044:Regression Analysis; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D012894:Sleep Stages; D013030:Spain / Q000453:epidemiology