Fatigue and daytime sleepiness in patients with myotonic dystrophy type 1: To lump or split?
Received 26 February 2008; received in revised form 18 February 2009; accepted 23 March 2009.
Abstract
We assessed the relationship and clinical correlates of fatigue and Excessive Daytime Sleepiness (EDS) in 200 myotonic dystrophy type 1 (DM1) patients by means of questionnaire and neuropsychological evaluation. Fatigue levels were higher in patients with EDS and daytime sleepiness levels higher in patients with excessive fatigue. However, EDS without fatigue was rarely observed. Also, DM1 patients with fatigue (with or without EDS) showed greater muscular impairment, CTG repeats, abnormalities regarding personality, depressive symptoms and lower health-related quality of life (HRQoL) than patients without these symptoms. These findings do not readily support the contention that fatigue and EDS constitute distinct clinical manifestations in DM1. Clinicians should systematically evaluate both symptoms since fatigue and EDS have a greater impact on HRQoL than fatigue alone. However, specific rating scales for fatigue in DM1 have yet to be devised.
aÉCOBES, Cégep de Jonquière, Jonquière, Qc, Canada
bDépartement des sciences de l’éducation et de psychologie, Université du Québec à Chicoutimi, 555, boul. de l’Université, Chicoutimi, Qc, Canada G7H 2B1
cCentre hospitalier affilié universitaire régional (CAUR) de Chicoutimi, Centre de Santé et de Services Sociaux de Chicoutimi, Chicoutimi, Qc, Canada
dService de Neurologie, CHU Montpellier, INSERM, U888, Université de Montpellier 1, France
eClinique des maladies neuromusculaires, Centre de Santé et de Services Sociaux de Jonquière, Jonquière, Qc, Canada
Corresponding author. Address: Département des sciences de l’éducation et de psychologie, Université du Québec à Chicoutimi, 555, boul. de l’Université, Chicoutimi, Qc, Canada G7H 2B1. Tel.: +1 418 547 2191x489; fax: +1 418 542 2853.
ABSTRACT