Prevalence and profile of sleep disturbances in Guillain-Barre Syndrome: a prospective questionnaire-based study during 10 days of hospitalization.
BACKGROUND
Sleep disturbances in Guillain-Barre Syndrome (GBS), though common, have not received focused attention.


OBJECTIVE
To study frequency and nature of sleep disturbances in patients with GBS, using validated questionnaires, and analyze the contributing factors.


METHODS
This prospective study included 60 patients fulfilling National Institute of Neurological and Communicative Diseases and Stroke (NINCDS) criteria for GBS (mean age: 32.7 ± 12.9 years; median: 30 years; M:F = 46:14), evaluated from 2008 to 2010. Data regarding sleep were collected on 10 consecutive days following admission using Richard Campbell Sleep score, St Mary's Hospital Sleep Questionnaire, and Pittsburgh Sleep Quality Index (PSQI) and correlated with various possible contributing factors like pain, paresthesia, anxiety, depression, autonomic dysfunctions, severity of disease, and therapeutic interventions among others.


METHODS
Qualitative and quantitative sleep disturbances were rather frequent and involved over 50% patients: abnormal PSQI - 13.3%, abnormal score on Richard scale - 51.6%, abnormal sleep onset latency - 35%, sleep fragmentation - 40%, and reduced sleep duration - 46.6%. The symptoms were severe during the first week of hospitalization and reduced thereafter. Sleep disturbances as scored on Richard scale significantly correlated with anxiety, pain, paresthesia, and severity of immobility (P < 0.05) but not with depression and use of analgesics or antineuritic drugs.


CONCLUSIONS
This study first of its kind suggests that sleep disturbance in GBS is frequent, multi-factorial, often disturbing, and varies during the course of illness. Routine enquiry into the sleep disturbances and timely intervention may reduce morbidity and improve their quality of life.
Departments of Neurology, National Institute of Mental Health and NeuroSciences, Bangalore, Karnataka, India.
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K
Karkare
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S
Sinha
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AB
Taly
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S
Rao
D000328:Adult; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015995:Prevalence; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires