Sleep Dysfunction in Multiple System Atrophy

Yang, Seok-Yeol; Seo, Jong-Geun

doi:2025.43.3.123

J Korean Neurol Assoc > Volume 43(3); 2025 > Article

Review Article

Journal of the Korean Neurological Association 2025;43(3): 123-131. doi: https://doi.org/10.17340/jkna.2025.0004

다계통위축증 환자에서의 수면장애

양석열¹, 서종근^1,2

¹경북대학교병원 신경과
²경북대학교 의과대학 신경과학교실

Sleep Dysfunction in Multiple System Atrophy

Seok-Yeol Yang MD¹, Jong-Geun Seo MD, PhD^1,2

¹Department of Neurology, Kyungpook National University Hospital, Daegu, Korea
²Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea

Corresponding Author: Jong-Geun Seo ,Tel: +82-53-200-5765, Fax: +82-53-422-4265, Email: jonggeun.seo@gmail.com

Received: March 13, 2025 Revised: May 11, 2025 Accepted: May 15, 2025 Published online: August 1, 2025

Abstract

Multiple system atrophy (MSA) is frequently associated with a range of sleep disorders, including insomnia, excessive daytime sleepiness, rapid eye movement sleep behavior disorder (RBD), restless legs syndrome, and sleep-disordered breathing. RBD is highly prevalent, often occurring early in the disease course and serving as a potential red flag for MSA. Stridor in MSA may cause fatal consequences if not treated properly. Sleep disturbances in MSA likely arise from a complex interplay of factors, including neurodegenerative processes affecting brain regions involved in sleep regulation, iatrogenic effects of medications, and the consequences of motor and autonomic dysfunction. Their consequences on life quality and on life expectancy are important. Sleep recordings should be recommended to all patients with MSA especially when stridor is suspected.

Key Words: Insomnia | Excessive daytime sleepiness | REM sleep behavior disorder | Restless legs syndrome | Stridor