Research Article| Volume 378, P163-166, July 15, 2017

A preliminary investigation of sleep quality in functional neurological disorders: Poor sleep appears common, and is associated with functional impairment

  • Christopher D. Graham
    Corresponding author at: Leeds Institute of Health Sciences, Worsley Building, University of Leeds, Leeds LS2 9LJ, UK.
    Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9LJ, UK

    Department of Clinical Neuropsychology, Leeds Teaching Hospitals NHS Trust, St. James University Hospital, Leeds LS9 7TF, UK
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  • Simon D. Kyle
    Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK
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      • Sleep dysfunction was common in both online and clinical FND samples.
      • In our online FND sample, sleep dysfunction comprised short and inefficient sleep.
      • Sleep quality was negatively associated with functional impairment.



      Functional neurological disorders (FND) are disabling conditions for which there are few empirically-supported treatments. Disturbed sleep appears to be part of the FND context; however, the clinical importance of sleep disturbance (extent, characteristics and impact) remains largely unknown. We described sleep quality in two samples, and investigated the relationship between sleep and FND-related functional impairment.


      We included a sample recruited online via patient charities (N = 205) and a consecutive clinical sample (N = 20). Participants completed validated measures of sleep quality and sleep characteristics (e.g. total sleep time, sleep efficiency), mood, and FND-related functional impairment.


      Poor sleep was common in both samples (89% in the clinical range), which was characterised by low sleep efficiency (M = 65.40%) and low total sleep time (M = 6.05 h). In regression analysis, sleep quality was negatively associated with FND-related functional impairment, accounting for 16% of the variance and remaining significant after the introduction of mood variables.


      These preliminary analyses suggest that subjective sleep disturbance (low efficiency, short sleep) is common in FND. Sleep quality was negatively associated with the functional impairment attributed to FND, independent of depression. Therefore, sleep disturbance may be a clinically important feature of FND.


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