Autonomic Dysfunction and Sleep Disorder in 35 Autoimmune Encephalitis

Considering that sleep disorders have garnered limited attention in patients with Autoimmune Encephalitis, often eclipsed by other prevailing neurological and psychiatric symptoms within this subgroup, identifying and addressing underlying sleep disturbances could alleviate AE-related complications and improve long-term outcomes. Consequently, the present study aims to ascertain the prevalence of sleep disorders and autonomic dysfunction in individuals grappling with autoimmune encephalitis within the confines of Isfahan City. This descriptive–analytical study initially identified 50 autoimmune encephalitis patients. Fifteen patients were excluded due to loss to follow-up secondary to relocation or death. Consequently, a total of 35 patients who presented to neurology clinics in Isfahan between March 2023 and August 2024 were ultimately enrolled in the study. To measure the Sleep status, the Pittsburgh Sleep Quality Index were used. Data were analyzed using SPSS software (version 16). Statistical analyses were conducted employing the chi-square test and independent samples t-test. A p-value of less than 0.05 was considered statistically significant. The results indicated that sleep disorders and autonomic dysfunction were observed in 65.7% and 62.9% of patients, respectively, with no significant correlation between clinical symptoms and EEG findings. Furthermore, there was no significant association between these findings and MRI results, except for a noteworthy difference between sleep disorders and normal MRI findings (P=0.012<0.05). There was no statistically significant association between normal versus abnormal EEG findings and the signs and symptoms of autonomic dysfunction (P=0.783). Similarly, no significant association was observed between abnormal MRI findings and autonomic dysfunction (P>0.05). In addition, no statistically significant relationship was found between normal versus abnormal EEG findings and sleep disturbances (P=0.710), nor between abnormal MRI findings and sleep disturbances (P>0.05). Seventeen patients (48.57%) presented with both sleep disturbances and autonomic dysfunction concurrently. A significant association was observed between sleep and autonomic disturbances and antibody type in patients with autoimmune encephalitis (P<0.05), with seronegative and anti-NMDA antibody–positive patients more frequently affected than those with other antibody types The findings indicate that the prevalence of sleep and autonomic disturbances in the autoimmune encephalitis patients is higher than that observed in the general population and is not necessarily associated with structurally detectable lesions on conventional imaging. • Autonomic Dysfunction and Sleep Disorder were associated with antibody type but not with EEG or MRI abnormalities. • Higher prevalence of Autonomic Dysfunction and Sleep Disorder compared with the general population.