AUTHOR=Hoxhaj Domeniko , Pascazio Alessia , Maestri Michelangelo , Ricci Giulia , Fabbrini Monica , Torresi Francesca Buracchi , Siciliano Gabriele , Bonanni Enrica 

TITLE=Excessive daytime sleepiness in myotonic dystrophy: a narrative review

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1389949

DOI=10.3389/fneur.2024.1389949

ISSN=1664-2295

ABSTRACT=This review aims to provide a comprehensive analysis of excessive daytime sleepiness (EDS) in myotonic dystrophy type 1 (DM1) and type 2 (DM2). EDS is a common and debilitating symptom in both forms of myotonic dystrophy, significantly impacting patients' quality of life. Polysomnographic studies have revealed a prominent dysregulation of REM sleep in DM1, suggesting a possible narcoleptic-like phenotype and alterations in NREM sleep, such as increased sleep instability and impaired delta power dissipation, that contributes to daytime sleepiness. While sleep-disordered breathing (SDB) and respiratory dysfunctions are prevalent in DM1 and DM2, their direct correlation with EDS remains complex and inconclusive. The review focuses on the purpose of examining the current understanding of EDS in these conditions, the difficulty in correctly accessing it, the recent findings related to its etiology and prevalence, and a summary of potential therapeutic implications.