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Sleep in ALS: more than discomfort or respiratory breathing disorder
  1. Adriano Chio,
  2. Alessandro Cicolin
  1. Department of Neuroscience, University of Turin, Torino, Italy
  1. Correspondence to Professor Adriano Chio, Department of Neuroscience, University of Turin, Torino, Italy; achio{at}

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Sleep disturbances in ALS are multifaceted and genetics is one of the culprits.

Amyotrophic lateral sclerosis (ALS) may directly affect sleep through immobilisation, fasciculations, muscle cramps, pain (musculoskeletal but also neuropathic) impaired swallowing function (with consequent sialorrhea, choking and saliva aspiration), or through specific sleep disorders, worsening physical and mental health and increasing the burden of the disease. The more prominent sleep disorders in patients with ALS are represented by sleep-related breathing disorders (SRBD) (45%–60%), sleep motor disorders (restless legs syndrome (RLS) and periodic limb movement disorder (PLMD), respectively, about 15% and 50%), rapid eye movement (REM) parasomnias (5%–20%), insomnia (65%, probably overestimated given that sleep could be fragmented or reduced secondary to other sleep disorders) and circadian rhythm …

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  • Contributors Both authors have contributed to the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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