Prevalence and profile of sleep disturbances in Guillain-Barre Syndrome: a prospective questionnaire-based study during 10 days of hospitalization

Introduction Sleep disturbances in Guillain-Barre Syndrome (GBS), though common, have not received focused attention. Objectives To study frequency and nature of sleep disturbances in patients with GBS, using validated questionnaires, and analyze the contributing factors. Materials and Methods This prospective study included 60 patients fulfilling National Institute of Neurological and Communicative Diseases and Stroke (NINCDS) criteria for GBS (mean age: 32.7 +/- 12.9 years; median: 30 years; M:F = 46:14), evaluated from 2008 to 2010. Data regarding sleep were collected on 10 consecutive days following admission using Richard Campbell Sleep score, St Mary's Hospital Sleep Questionnaire, and Pittsburgh Sleep Quality Index (PSQI) and correlated with various possible contributing factors like pain, paresthesia, anxiety, depression, autonomic dysfunctions, severity of disease, and therapeutic interventions among others. Observations Qualitative and quantitative sleep disturbances were rather frequent and involved over 50% patients: abnormal PSQI 13.3%, abnormal score on Richard scale 51.6%, abnormal sleep onset latency 35%, sleep fragmentation 40%, and reduced sleep duration 46.6%. The symptoms were severe during the first week of hospitalization and reduced thereafter. Sleep disturbances as scored on Richard scale significantly correlated with anxiety, pain, paresthesia, and severity of immobility (P < 0.05) but not with depression and use of analgesics or antineuritic drugs. Conclusions This study first of its kind suggests that sleep disturbance in GBS is frequent, multi-factorial, often disturbing, and varies during the course of illness. Routine enquiry into the sleep disturbances and timely intervention may reduce morbidity and improve their quality of life.