P038 Prevalence of sleep disturbances in Huntington disease: a systematic review

Abstract Introduction Huntington disease genetic expansion carriers (HDGECs) have a rare, genetic mutation causing neurodegeneration with motor, cognitive, and psychiatric features. Sleep disturbances are common and may impact quality of life (QoL), but the prevalence and nature of sleep changes have not been systematically studied. To address this gap, we conducted a systematic review and meta-analysis of the prevalence of sleep disturbances among HDGECs. Methods We searched MEDLINE, EMBASE, PsychINFO, and CINAHL Plus (inception to July 2024), using exploded headings and sleep-related terms intersected with “Huntington disease”. Two authors independently screened the output and extracted data. Where four or more studies used the same measure, we meta-analysed data using a random effects model. Results We screened 2507 abstracts to identify 25 articles that met inclusion criteria. The prevalence of self-report sleep disturbance in HDGECs of: poor sleep quality was 61% (95%CI 54-68%, n = 7, Pittsburgh Sleep Quality Index); sleepiness was 15% (95%CI 10-21%, n = 7, Epworth Sleepiness Scale); and use of sleep medications was 29% (95%CI 13-45%, n = 4). The prevalence of objectively-measured sleep disturbances of: sleep-disordered breathing was 9% (95%CI 4-14%, n = 6, AHI > 5/hour); periodic limb movements was 35% (95%CI 5-66%, n = 4, PLM index>15/hour), REM sleep behaviour disorder was 3% (95%CI 0-6%, n = 4), and REM sleep without atonia was 5% (95%CI 0-10%, n = 4). Discussion Sleep disturbances indicated by poor sleep quality, use of sleep medications and periodic limb movements during sleep were prevalent in HDGECs. Further research is crucial for characterising changes in sleep which may inform future sleep interventions improving QoL in HDGECs.