Sleep Dysfunction in Multiple System Atrophy

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.