Sleep disturbances and amyotrophic lateral sclerosis

Sleep disturbances are common in neurodegenerative diseases. A team of researchers from Strasbourg has very recently demonstrated that these disturbances are also present in patients suffering from amyotrophic lateral sclerosis, and this early on, before the first symptoms appear.

𝐀𝐦𝐲𝐨𝐭𝐫𝐨𝐩𝐡𝐢𝐜 𝐥𝐚𝐭𝐞𝐫𝐚𝐥 𝐬𝐜𝐥𝐞𝐫𝐨𝐬𝐢𝐬 (ALS) is a serious neurodegenerative disease characterized by the 𝐩𝐫𝐨𝐠𝐫𝐞𝐬𝐬𝐢𝐯𝐞 𝐝𝐞𝐚𝐭𝐡 𝐨𝐟 𝐦𝐨𝐭𝐨𝐫 𝐧𝐞𝐮𝐫𝐨𝐧𝐬, leading to 𝐩𝐫𝐨𝐠𝐫𝐞𝐬𝐬𝐢𝐯𝐞 𝐩𝐚𝐫𝐚𝐥𝐲𝐬𝐢𝐬 of the muscles involved in voluntary movement, phonation and swallowing. Death generally occurs 3 to 5 years after diagnosis, due to damage to the respiratory muscles. There is currently 𝐧𝐨 𝐜𝐮𝐫𝐞 for this disease, which is treated symptomatically. 𝐒𝐥𝐞𝐞𝐩 𝐝𝐢𝐬𝐨𝐫𝐝𝐞𝐫𝐬 have been well characterized in other neurodegenerative diseases, but have remained little studied in ALS.

The study by Guillot et al. published in 𝑆𝑐𝑖𝑒𝑛𝑐𝑒 𝑇𝑟𝑎𝑛𝑠𝑙𝑎𝑡𝑖𝑜𝑛𝑎𝑙 𝑀𝑒𝑑𝑖𝑐𝑖𝑛𝑒 showed an 𝐢𝐧𝐜𝐫𝐞𝐚𝐬𝐞 𝐢𝐧 𝐰𝐚𝐤𝐞𝐟𝐮𝐥𝐧𝐞𝐬𝐬 and a 𝐝𝐞𝐜𝐫𝐞𝐚𝐬𝐞 𝐢𝐧 𝐧𝐨𝐧-𝐫𝐚𝐩𝐢𝐝 𝐞𝐲𝐞 𝐦𝐨𝐯𝐞𝐦𝐞𝐧𝐭 𝐬𝐥𝐞𝐞𝐩 in ALS patients and in asymptomatic patients carrying genes that constitute risk factors for the disease. Similar disturbances in sleep architecture were also found 𝐢𝐧 𝐦𝐨𝐮𝐬𝐞 𝐦𝐨𝐝𝐞𝐥𝐬 𝐨𝐟 𝐀𝐋𝐒, and partially normalized by injection of 𝐦𝐞𝐥𝐚𝐧𝐢𝐧-𝐜𝐨𝐧𝐜𝐞𝐧𝐭𝐫𝐚𝐭𝐢𝐧𝐠 𝐡𝐨𝐫𝐦𝐨𝐧𝐞 or oral administration of an o𝐫𝐞𝐱𝐢𝐧 𝐚𝐧𝐭𝐚𝐠𝐨𝐧𝐢𝐬𝐭.

These results suggest that these sleep disturbances may 𝐩𝐫𝐞𝐜𝐞𝐝𝐞 𝐭𝐡𝐞 𝐨𝐧𝐬𝐞𝐭 𝐨𝐟 𝐬𝐲𝐦𝐩𝐭𝐨𝐦𝐬 and be improved by the administration of neuropeptides involved in the regulation of the sleep/wake rhythm, potentially enabling 𝐞𝐚𝐫𝐥𝐲 𝐝𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬 of this condition and 𝐛𝐞𝐭𝐭𝐞𝐫 𝐦𝐚𝐧𝐚𝐠𝐞𝐦𝐞𝐧𝐭.