Sleep medicine

Sleep medicine

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Group leader

Luigi Ferini-Strambi

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Recently, evidence has emerged for a bidirectional relationship between sleep and neurological disorders. First, sleep-wake disorders (SWDs) are very common and may be the first manifestation of underlying neurological disorders. Secondly, SWDs may represent an independent risk factor for neurologic morbidities. Thirdly, sleep-wake function may influence the course/outcome of neurological disorders.

Research activity

Our major research interests are:

  • The evaluation of patients affected by restless legs syndrome (RLS) and periodic leg movements during sleep (PLMS). We have conducted epidemiological studies for evaluating RLS prevalence in multiple sclerosis, or cancer. We have conducted a clinical and polysomnographic study in a very large sample of patients in order to define the RLS phenotype. PLMS shows in the majority of RLS patients a progressively decreasing course during the night. We evaluated the change in PLMS by dopamine agonists in RLS patients. The reduction in PLMS index was accompanied by no change in sleep microstructure, in contrast to clonazepam that reduced the sleep fragmentation, but not the PLM index.
  • REM Sleep Behaviour Disorder (RBD), a REM sleep parasomnia that may an early manifestation of neurodegenerative disorders. We have conducted clinical, neurophysiologic and neuropsychological studies aimed to detect early markers of neurodegenerative dysfunction in RBD patients.
  • OSA, the most common sleep-related breathing disorder. OSA may accelerate the onset of mild cognitive impairment and Alzheimer's disease and might also represent an independent risk factor for Parkinson's disease. We investigated the cognitive deficits and the corresponding brain morphology changes in OSA, and the changes after treatment. A reversal of the focal reductions of greymatter volume and of the diffuse reduction of white matter fiber integrity in multiple brain areas was observed after treatment with Continuous Positive Air Pressure.