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Abstract Details

Sleep Disorders In Anti-NMDAR Encephalitis
Autoimmune Neurology
S39 - Autoimmune and Paraneoplastic Neurological Disorders: Clinical Characteristics and Diagnosis (1:36 PM-1:48 PM)
004
To describe the sleep disorders in anti-NMDA receptor encephalitis (anti-NMDARe)
Patients with anti-NMDARe often have sleep problems. The severity and complexity of the accompanying neuropsychiatric symptoms, mask these sleep disorders, complicate their assessment, and explain the lack of prior studies
Patients recovering from anti-NMDARe were invited to participate in a prospective observational single center study including comprehensive clinical, video-polysomnography (V-PSG) sleep assessment and neuropsychological evaluation. Age and sex-matched healthy participants served as controls
Eighteen patients (89% female, median age 26 years, IQR 21-29) and 21 controls (81% female, median age 23 years, IQR 18-26) were included. In the acute stage, 16 (89%) patients reported insomnia and 2 hypersomnia (1 rapidly changed to insomnia). After the acute stage, 14 (78%) had hypersomnia. At study-admission (median 183 days after disease-onset, IQR 110-242) 8 patients still had hypersomnia, 1 insomnia, and 9 normal sleep duration. Patients had more daytime sleepiness than controls (higher Barcelona Sleepiness Index, p=0.02, and Epworth Sleepiness Score, p=0.04), but a similar perception of sleep quality. On V-PSG, sleep efficiency was similar in both groups although patients had more frequently multiple and longer confusional arousals in NREM sleep (p=0.03). Additionally, 13 (72%) patients had cognitive deficits, 12 (67%) psychological, social, or occupational disability, and 33% depression or mania. Between disease-onset and the last follow-up, 14 (78%) patients developed hyperphagia, and 6 (33%) hypersexuality (2 requiring hospitalization), all associated with sleep dysfunction. At study-admission, patients had a higher body mass index compared with controls (median, IQR: 23.5, 22.3-30.2 vs. 20.5, 19.1-21.1; p=0.007)
Sleep disturbances are frequent in anti-NMDARe. They show a temporal pattern (predominantly insomnia at onset; hypersomnia during recovery), associate with behavioral and cognitive changes, and can occur with confusional arousals during NREM sleep.
Authors/Disclosures

PRESENTER 		No disclosure on file
No disclosure on file
Eugenia Martinez-Hernandez, MD (Hospital Clinic Barcelona) Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. The institution of Dr. Martinez-Hernandez has received research support from Instituto de Salud Carlos III. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings with Sanofi. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings and speaker honoraria with UCB. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a speaker honoraria with Alexion. Dr. Martinez-Hernandez has received personal compensation in the range of $0-$499 for serving as a speaker honoraria with Terumo. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings with Janssen. Dr. Martinez-Hernandez has received personal compensation in the range of $500-$4,999 for serving as a support for attending meetings with CSL Behring.
Thais Armangue, MD (IDIBAPS-HClinic) Dr. Armangue has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. The institution of Dr. Armangue has received research support from ISCIII(Spanish institute of health) -PI21/00316, Marato TV3, La Caixa Research Foundadion, Pablove Foundation (689368), Torrons Vicens Foundation (PFNR0144), 2021 Invest AEP.
Joan Santamaria, MD (Hospital Clinic of Barcelona) Joan Santamaria, MD has nothing to disclose.
Josep O. Dalmau, MD, PhD, FAAN Dr. Dalmau has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astellas Research Institute of America. Dr. Dalmau has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen Research & Development . Dr. Dalmau has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. An immediate family member of Dr. Dalmau has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Dalmau has received research support from Sage Therapeutics. The institution of Dr. Dalmau has received research support from Edmond J.Safra Foundation . The institution of Dr. Dalmau has received research support from La Caixa Foundation. The institution of Dr. Dalmau has received research support from Spanish Ministry of Health (ISCIII). The institution of Dr. Dalmau has received research support from Euroimmun, Inc. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care.