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Background <p>Sleep-disordered breathing (SDB) is increasingly recognized in myasthenia gravis (MG), yet potential differences in sleep respiratory patterns between antibody-defined MG subtypes remain poorly understood. We aimed to evaluate sleep disorders and polysomnographic characteristics in patients with acetylcholine receptor antibody–positive (AChR-MG) and muscle-specific tyrosine kinase antibody–positive (MuSK-MG) generalized MG.</p> Methods <p>Eighteen clinically stable MG patients (9 AChR-MG, 9 MuSK-MG) and 9 healthy controls underwent attended overnight polysomnography followed by the Multiple Sleep Latency Test (MSLT). Standardized sleep questionnaires and MG clinical scales were administered to assess sleep-related symptoms and disease severity.</p> Results <p>Obstructive sleep apnea was detected in 89% of AChR-MG and 78% of MuSK-MG patients. Both MG subgroups showed significantly higher apnea–hypopnea index values compared with controls (<i>p</i> &lt; 0.05). Although overall AHI severity did not differ significantly between antibody groups, distinct respiratory patterns were observed. Respiratory events clustered predominantly during REM sleep in AChR-MG, whereas MuSK-MG patients exhibited more frequent events during NREM or supine sleep.</p> Conclusions <p>Sleep-disordered breathing appears to be common in MG, but polysomnographic patterns may differ according to antibody subtype. REM-predominant respiratory events in AChR-MG and NREM or positional predominance in MuSK-MG may reflect differences in muscle involvement between these subtypes. These findings suggest that antibody-specific mechanisms may influence nocturnal respiratory dysfunction in MG and highlight the importance of targeted sleep assessment in this population.</p>

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Sleep disorders in patients with myasthenia gravis based on antibody subtypes: a polysomnographic study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月15日

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  • Beyza Arslan,
  • Kayihan Uluc,
  • Kadriye Agan,
  • Pinar Kahraman Koytak,
  • Gulin Sunter

摘要

Background

Sleep-disordered breathing (SDB) is increasingly recognized in myasthenia gravis (MG), yet potential differences in sleep respiratory patterns between antibody-defined MG subtypes remain poorly understood. We aimed to evaluate sleep disorders and polysomnographic characteristics in patients with acetylcholine receptor antibody–positive (AChR-MG) and muscle-specific tyrosine kinase antibody–positive (MuSK-MG) generalized MG.

Methods

Eighteen clinically stable MG patients (9 AChR-MG, 9 MuSK-MG) and 9 healthy controls underwent attended overnight polysomnography followed by the Multiple Sleep Latency Test (MSLT). Standardized sleep questionnaires and MG clinical scales were administered to assess sleep-related symptoms and disease severity.

Results

Obstructive sleep apnea was detected in 89% of AChR-MG and 78% of MuSK-MG patients. Both MG subgroups showed significantly higher apnea–hypopnea index values compared with controls (p < 0.05). Although overall AHI severity did not differ significantly between antibody groups, distinct respiratory patterns were observed. Respiratory events clustered predominantly during REM sleep in AChR-MG, whereas MuSK-MG patients exhibited more frequent events during NREM or supine sleep.

Conclusions

Sleep-disordered breathing appears to be common in MG, but polysomnographic patterns may differ according to antibody subtype. REM-predominant respiratory events in AChR-MG and NREM or positional predominance in MuSK-MG may reflect differences in muscle involvement between these subtypes. These findings suggest that antibody-specific mechanisms may influence nocturnal respiratory dysfunction in MG and highlight the importance of targeted sleep assessment in this population.