Estudo do sono na ataxia espinocerebelar do tipo 6 : avaliação de escalas clínicas, polissonografia e qualidade de vida

• Autor(a) principal: Rueda, Adriana Dourado [UNIFESP]
• Data de Publicação: 2017
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5453848; http://repositorio.unifesp.br/handle/11600/49913
• topic: Spinocerebellar ataxias; Sleep; Polysomnography; Sono; Ataxias espinocerebelares; Polissonografia

Aims: The aim of study was investigating spinocerebellar ataxia type 6 (SCA6), by questionnaires and polysomnography, the changes in sleep patterns in patients attended in our day clinic. To investigate through the use of questionnaires: quality of life (SF-36), daily life activity, depression, anxiety, functional independence measure, falls efficacy scale. Methods: All patients with this diagnosis were invited to follow the study in our clinic. All patients with this diagnosis were invited to attend our clinic to carry out the study. A total of fourteen patients, twelve patients were included, six males and six females. After they were invited, all patients signed the consent form, underwent a clinical evaluation, answered the questionnaires and performed polysomnography test during all night. These patients were paired with control group volunteers belonging to a database, by age, body mass index and sex, the polysomnography data and questionnaires being subsequently compared. This study was approved by the Research Ethics Committee (approval number 165.432). Results: Patients with SCA6 had increase snoring when compared to the control group (p=0.01), as well as an increase in the awakening rate related to respiratory events (p=0.03) and central apnea events during sleep (p=0.024), increased N1 sleep stage (p=0.02) and a reduction in N3 sleep stage (p=0.05). Using the International Cooperative Ataxia Rating Scale (ICARS), the average of all the patients was 33.25 (± 18.4) and the mean of Scale for the Assessment and Rating of Ataxia (SARA) was 12.6 (± 7.6). Eight patients had a great difficulty in initiating or maintaining sleep according to the Pittsburgh sleep quality index. About the quality of life (in SF-36), it was found that the main losses in patients relate to energy, functional capacity and social functioning. The mean Functional Independence Measure (FIM) was 113.25, the loss being purely in the motor parameters. All the patients scored higher for falls according to the Falls Efficacy Scale (FES), and nine patients scored in respect of recurrent falls. Eleven patients were independent as far as their daily life activities. One patient scored for depression and four patients scored for a tendency to anxiety. Conclusion: Patients studied with SCA6 had a reduction in slow-wave sleep and a high frequency of snoring and sleep disorders breathing, when compared to the controls. Patients presented alterations that appeared to have little impact on their daily lives when on a smaller scale when compared with other ataxias. Keywords: Spinocerebellar ataxias, Sleep, Polysomnography.