Abstract
Purpose of review
The aim of this article was to review the different sleep disorders associated with Wilson’s disease (WD), their mechanisms and their treatments.
Recent findings
Some of these disorders such as REM sleep behavior disorder or sleepiness can appear as a prodromal phase phenomenon in WD allowing an early treatment of the disease and sometimes a resolution of the sleep disorder.
Summary
Sleep disorders in WD are frequent combining insomnia, daytime sleepiness, restless legs syndrome (RLS), cataplexy-like episodes, and REM sleep behavior disorder (RBD). Sleep recordings confirm these disorders. Mechanisms involved in these disorders are complex associating (a) lesions of the pathways regulating sleep and wake or mood but also controlling movement, (b) iatrogenic effects of the treatments, and (3) consequences of the motor or dysautonomic or metabolic disorders.
Similar content being viewed by others
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Tanzi R, Petrukhin K, Chernov I, et al. The Wilson disease gene is a copper transporting ATPase with homology to the Menkes disease gene. Nat Genet. 1993;3:344–50.
• Woimant F, Trocello J-M. Disorders of heavy metals. Elsevier, editor. Handb Clin Neurol. 2014;120:851–64. Insightful review of the current clinical, diagnostic, and treatment challenges in heavy metal disorders.
Poujois A, Woimant F. Wilson’s disease: a 2017 update. Clin Res Hepatol Gastroenterol 2018 (in press).
Biswas S, Paul N, Das SK. Nonmotor manifestations of Wilson’s disease. Int Rev Neurobiol. 2017;134:1443–59.
Giagheddu M, Tamburini G, Piga M, Tacconi P, Giagheddu A, Serra A, et al. Comparison of MRI, EEG, EPs and ECD-SPECT in Wilson’s disease. Acta Neurol Scand. 2001;103:71–81.
Oder W, Prayer L, Grimm G, Spatt J, Ferenci P, Kollegger H, et al. Wilson’s disease: evidence of subgroups derived from clinical findings and brain lesions. Neurology. 1993;43:120.
• Poujois A, Mikol J, Woimant F. Wilson disease: brain pathology. Handb Clin Neurol. 2017;142:77–89. A detailed review of macroscopic and microscopic neuropathological abnormalities described in Wilson’s disease and description of the distribution of copper in different parts of the brain.
Portala K, Westermark K, Ekselius L, Broman J-E. Sleep in patients with treated Wilson’s disease. A questionnaire study. Nord J Psychiatry. 2002;56:291–7.
• Nevsimalova S, Buskova J, Bruha R, Kemlink D, Sonka K, Vitek L, et al. Sleep disorders in Wilson’s disease. Eur J Neurol. 2011;18:184–90. The only study on sleep disorders in WD with objective measures on sleepiness
Netto A, Sinha S, Taly A, Panda S. Sleep in Wilson’s disease: questionnaire based study. Ann Indian Acad Neurol. 2011;14:31–4.
•• Trindade MC, Bittencourt T, Lorenzi-Filho G, Alves RC, de Andrade DC, Fonoff ET, et al. Restless legs syndrome in Wilson’s disease: frequency, characteristics, and mimics. Acta Neurol Scand. 2017;135:211–8. Interesting study focusing on RLS in WD.
•• Tribl GG, Trindade MC, Bittencourt T, Lorenzi-Filho G, Cardoso Alves R, Ciampi de Andrade D, et al. Wilson’s disease with and without rapid eye movement sleep behavior disorder compared to healthy matched controls. Sleep Med. 2016;17:179–85. Interesting study focusing on RBD in WD.
Netto A, Sinha S, Taly A, Panda S, Rao S. Sleep in Wilson’s disease: a polysomnography-based study. Neurol India. 2010;58:933.
American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. 2014; (Darien, IL American Academy of Sleep Medicine).
De Cruz S, Espiritu J, Zeidler M, Wang T. Sleep disorders in chronic liver disease. Semin Respir Crit Care Med. 2012;33:26–35.
Litwin T, Dusek P, Członkowska A. Symptomatic treatment of neurologic symptoms in Wilson disease. Handb Clin Neurol. 2017;142:211–23.
Akil M, Brewer G. Psychiatric and behavioral abnormalities in Wilson’s disease. Adv Neurol. 1995;65:171–8.
Litwin T, Dusek P, Szafrański T, Dzieżyc K, Członkowska A, Rybakowski J. Psychiatric manifestations in Wilson’s disease: possibilities and difficulties for treatment. Ther Adv. 2018;8:199–211.
Dening TR, Berrios GE. Wilson’s disease: psychiatric symptoms in 195 cases. Arch Gen Psychiatry. 1989;46:1126–34.
Shanmugiah A, Sinha S, Taly AB, Prashanth LK, Tomar M, Arunodaya GR, et al. Psychiatric manifestations in Wilson’s disease: a cross-sectional analysis. J Neuropsychiatry Clin Neurosci. 2008;20:81–5.
Guillaud O, Dumortier J, Sobesky R, Debray D, Wolf P, Vanlemmens C. Long term results of liver transplantation for Wilson’s disease: experience in France. J Hepatol. 2014;60:579–89.
Laurencin C, Brunet A-S, Dumortier J, Lion-François L, Thobois S, Mabrut J. Liver transplantation in Wilson’s disease with neurological impairment: evaluation in 4 patients. Eur Neurol. 2017;77:5–15.
Tarter R, Van Thiel D, Hegedus A, Schade R, Gavaler J, Starzl T. Neuropsychiatric status after liver transplantation. J Lab Clin Med. 1984;103:776–82.
Zimbrean P, Schilsky M. The spectrum of psychiatric symptoms in Wilson’s disease: treatment and prognostic considerations. Am J Psychiatry. 2015;172:1068–72.
Bergonzi P, Chiurulla C, Cianchetti, et al. Clinical pharmacology as an approach to the study of biochemical sleep mechanisms: the action of l-dopa. Conflin Neurol. 1974;36:5–22.
Huang Z, Deng J, Borjigin J. A novel H28Y mutation in LEC rats leads to decreased NAT protein stability in vivo and in vitro. J Pineal Res. 2005;39:84–90.
Borjigin J, Payne A, Deng J, Li X, Wang M, Ovodenko B. A novel pineal night-specific ATPase encoded by the Wilson disease gene. J Neurosci. 1999;19:1018–26.
• Scheiber I, Mercer J, Dringen R. Metabolism and functions of copper in brain. Prog Neurobiol. 2014;116:33–57. A general and comprehensive review of metabolism and functions of copper in brain.
Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep. 1991;14:540–5.
Littner MR, Kushida C, Wise M, et al. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep. 2005;28:113–21.
Firneisz G, Szlay F, Halasz P, Komoly S. Hypersomnia in Wilson’s disease : an unusual symptom in an unusual case. Acta Neurol Scand. 2000;101:286–8.
Amann VC, Maru NK, Jain V. Hypersomnolence in Wilson disease. J Clin Sleep Med. 2015;11:1341–3.
Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, et al. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated international restless legs syndrome study group (IRLSSG) consensus criteria - history, rationale, description, and significance. Sleep Med. 2014;15:860–73.
Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, et al. Validation of the international restless legs syndrome study group rating scale for restless legs syndrome. Sleep Med. 2003;4:121–32.
Papapetripoulos S, Singer C. Painless legs moving toes in a patient with Wilson’s disease. Mov Disord. 2006;21:579–80.
• Bandmann O, Weiss KH, Kaler SG. Wilson’s disease and other neurological copper disorders. Lancet Neurol. 2015;14:103–13. A comprehensive review of Wilson’s disease including its phenomenology, pathophysiology, imaging findings, and treatment.
Rijsman RM, Schoolderman LF, Rundervoort RS, Louter M. Restless legs syndrome in Parkinson’s disease. Parkinsonism Relat Disord. 2014;20:S5–9.
De Cock VC, Bayard S, Yu H, Grini M, Carlander B, Postuma R, et al. Suggested immobilization test for diagnosis of restless legs syndrome in Parkinson’s disease. Mov Disord. 2012;27:743–9.
Earley CJ, Connor J, Garcia-Borreguero D, Jenner P, Winkelman J, Zee PC, et al. Altered brain iron homeostasis and dopaminergic function in restless legs syndrome (Willis-Ekbom disease). Sleep Med. 2014;15:1288–301.
Connor JR, Wang XS, Allen RP, Beard JL, Wiesinger JA, Felt BT, et al. Altered dopaminergic profile in the putamen and substantia nigra in restless leg syndrome. Brain. 2009;132:2403–12.
Pittock SJ, Parrett T, Adler CH, Parisi JE, Dickson DW, Ahlskog JE. Neuropathology of primary restless leg syndrome: absence of specific tau- and alpha-synuclein pathology. Mov Disord. 2004;19:695–9.
Barthel H, Hermann W, Kluge R, Hesse S, Collingridge DR, Wagner A, et al. Concordant pre- and postsynaptic deficits of dopaminergic neurotransmission in neurologic Wilson disease. Am J Neuroradiol. 2003;24:234–8.
García-Borreguero D, Williams A-M. An update on restless legs syndrome (Willis-Ekbom disease): clinical features, pathogenesis and treatment. Curr Opin Neurol. 2014;27:493–501.
Dusek P, Bahn E, Litwin T, Jabłonka-Salach K, Łuciuk A, Huelnhagen T, et al. Brain iron accumulation in Wilson disease: a post mortem 7 tesla MRI - histopathological study. Neuropathol Appl Neurobiol. 2017;43:514–32.
Schenck CH, Mahowald MW. REM sleep behavior disorder: clinical, developmental, and neuroscience perspectives 16 years after its formal identification in SLEEP. Sleep. 2002;25:120–38.
Comella CL, Nardine TM, Diederich NJ, Stebbins GT. Sleep-related violence, injury, and REM sleep behavior disorder in Parkinson’s disease. Neurology. 1998;51:526–9.
Kunz D, Bes F. Melatonin effects in a patient with severe REM sleep behavior disorder: case report and theoretical considerations. Neuropsychobiology. 1997;36:211–4.
Tribl GG, Bor-Seng-Shu E, Trindade MC, Lucato LT, Teixeira MJ, Barbosa ER. Wilson’s disease presenting as rapid eye movement sleep behavior disorder: a possible window to early treatment. Arq Neuropsiquiatr. 2014;72:653–8.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
This article is part of the Topical Collection on Sleep Disorders
Rights and permissions
About this article
Cite this article
Cochen De Cock, V., Girardot-Tinant, N., Woimant, F. et al. Sleep Abnormalities in Wilson’s Disease. Curr Treat Options Neurol 20, 46 (2018). https://doi.org/10.1007/s11940-018-0531-4
Published:
DOI: https://doi.org/10.1007/s11940-018-0531-4