AUTHOR=Yan Jingwen , Yang Minhui , Li Michael Ke , Huang Yangyu , Tan Ying , Shi Jiayu , Fan Qianqian , Zhu Zhu , Guan Yuzhou , Cui Liying 

TITLE=Treatment of insomnia in myasthenia gravis—A prospective study on non-benzodiazepine hypnotics in the treatment of myasthenia gravis patients with insomnia

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1266862

DOI=10.3389/fneur.2023.1266862

ISSN=1664-2295

ABSTRACT=Objectives: To evaluate the efficacy and safety of non-benzodiazepine hypnotics in the treatment of myasthenia gravis (MG) patients with insomnia.: This is a prospective longitudinal study. Outpatients who met the criteria for stable MG and insomnia diagnosis according to the International Classification of Sleep Disorders (3rd edition) were included in the study. They took a regular dose of nonbenzodiazepine hypnotics (zolpidem 10mg per night or zopiclone 7.5mg per night) based on their own preferences. Patient received psychotherapy (including sleep health education), and was followed-up for 4-5 weeks. Cases with lung diseases, respiratory disorders, or inappropriate use of hypnotic medications were excluded. Primary outcome is the difference of total Pittsburgh Sleep Quality Index (PSQI) score between baseline and the end of follow-up period. Secondary outcomes include the difference of Myasthenia Gravis Activities of Daily Living(MG-ADL)score, 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), and the Patient Health Questionnaire-9(PHQ-9) between baseline and the end of follow-up period,and the safety of medication.Results: A total of 75 MG patients with insomnia were included in this study. After 4-5 weeks treatment,total PSQI score and MG-ADL score was lower than baseline(p <0.01). No patients had an increased MG-ADL score. Incidence rate of adverse events was 16.0% (12 cases), including dizziness (6 cases, 8.0%), drowsiness (3 cases, 4.0%), fatigue (2 cases, 2.7%), nausea (1 case, 1.3%), all of which were mild. No patients had new onset breathing disorders.Non-benzodiazepine hypnotics are safe and effective for stable MG patients who need insomnia treatment.