Report of an EFNS task force on management of sleep disorders in neurologic disease (degenerative neurologic disorders and stroke)

Abstract

A task force to develop guidelines for diagnostic evaluation and treatment of sleep disorders in degenerative neurologic disorders and stroke was initiated by the European Federation of Neurological Societies (EFNS). The aims were to provide evidence-based recommendations in the management of sleep disorders associated with degenerative neurologic disorders and stroke. Neurological patients often have significant sleep disorders like sleep-related breathing disorders (SBD), insomnia, sleep-related motor and rapid eye movement behavioral disorders affecting nocturnal sleep and daytime function. A polysomnography (PSG) is usually a diagnostic minimum for the diagnoses of the most commonly reported sleep disorders in patients with neurologic diseases. A full video-PSG/video-EEG-PSG should be considered in patients with nocturnal motor and/behavior manifestations. Respiratory polygraphy has a moderate sensitivity and specificity in the diagnosis of SBD without neurologic diseases, but its value in patients with neurologic diseases has not been evaluated. Oximetry has a poor sensitivity-specificity for the identification of SDB. Continuous and bi-level positive airway pressure devices are the most effective treatment of SDB in patients with neurologic diseases. There is a need for further studies focusing on the diagnostic procedures and treatment modalities in patients with sleep disorders and degenerative neurologic diseases and stroke.