Objective: To study the sleep abnormalities in patients with HD by usingquestionnaire and Video Polysomnography (VPSG) and correlate with the eye movement abnormalities.

Background: About 87.8% of the patients report some sleep disturbance in subjective questionnaire, out of which 62% reported it as important. It includes frequent awakenings, early morning sleepiness, periodic jerks, reduced sleep efficiency, shortened REM sleep and difficulty to fall asleep

Method: It was a prospective cross-sectional case control study. The patients were recruited from Movement Disorders Clinic of NIMHANS hospital, Bengaluru, India. These patients underwent clinical examination and eye movement assessment. They were assesses by validated scales for sleep quality, excessive day time somnolence, restless legs syndrome and REM sleep behaviour disorders followed by overnight VPSG.

Results: The HD cases recruited 29 with a mean age of 39.7 ± 10.3 years and controls were 31.0 ± 5.8 years. 65.5% and 80% were male in cases and controls. CAG repeat length ranged from 36 – 62. Saccades were abnormal among (86%) patients with HD. Vertical saccades were more affected than horizontal. Poor sleep quality was seen in 68%. Sleep architecture was disturbed. Sleep efficiency 66%. Sleep transitions were high. The percentage of wake and WASO was significantly high (31%) for patients compared to controls (16.6%). The percentage of N2 and REM sleep very less (p<0.01) compared to controls. Sleep cycle numbers were also less in patients with respect to controls(p<0.01).REM sleep was reduced in HD patients(p<0.01),and OKN impairment severity correlated with the disease severity(p<0.01). No correlation between REM sleep percentage, severity of illness and OKN impairment severity was detected(p>0.05).

Conclusion: Indian patients with HD have high frequency of poor quality of sleep, have reduced REM sleep and significant association with eye movement abnormalities. Thus, sleep is an important non motor symptom in patients with HD which requires adequate attention by the clinicians.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-and-polysomnographic-abnormalities-in-indian-patients-with-huntingtons-disease/