AUTHOR=Blaszczyk Bartlomiej , Wieckiewicz Mieszko , Kusztal Mariusz , Michalek-Zrabkowska Monika , Lachowicz Gabriella , Mazur Grzegorz , Martynowicz Helena 

TITLE=Fabry disease and sleep disorders: a systematic review

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1217618

DOI=10.3389/fneur.2023.1217618

ISSN=1664-2295

ABSTRACT=Background: Fabry disease (FD) is an X-chromosome-linked disorder characterized by a reduced or complete absence of the enzyme α-galactosidase, resulting in the accumulation of lysosomal globotriaosylceramide. Despite the presence of these deposits in multiple organs, the problem of sleep disorders within this population has very rarely been documented.Objective: The study aimed to investigate the types and prevalence of sleep disorders among patients with FD.Methods: Screening of the following medical databases using key terms was performed on the 10th of February 2023: PubMed, Scopus, and Embase. A total of 136 records were identified.The quality assessment of the studies was conducted by using tools from the National Institutes of Health (NIH) and critical appraisal tools from the Joanna Briggs Institute (JBI).Results: The study included nine papers on sleep disorders in patients with FD. The overall quality of the majority of these studies was assessed as either poor or fair. Among 330 patients, there was a slightly higher representation of females (56%). Sleep problems manifested 4 to 5 years after the onset of FD, and sometimes even after 10 to 11 years.Genotypes of disease associated with sleep problems were rarely described. Within the FD population, the most commonly reported conditions were excessive daytime sleepiness (EDS), as well as obstructive and central sleep apnea (OSA, CSA). However, EDS occurred more frequently in FD patients, while the prevalence of OSA and CSA were within the ranges observed in the general population. The studies included indicated a lack of associations between organ impairment by primary disease and EDS and OSA. The effectiveness of enzyme replacement therapy (ERT) in treating sleep disorders was not demonstrated.The findings of this report revealed the presence of many sleep-related disorders within the FD population. However, very few studies on this subject are available, and their limited results make it difficult to truly assess the real extent of the prevalence of sleep disturbances among these individuals. There is a need for conducting further studies on this topic, involving a larger group of patients. It is important to note that there are no guidelines available for the treatment of sleep disorders in FD.