Depression as the primary cause of insomnia and excessive daytime sleepiness in a family with multiple cases of spinocerebellar ataxia

Chun Hsien Hsu, Yen Lin Chen, Dee Pei, Shu Man Yu, I. Chao Liu

Research output: Contribution to journalArticle

3 Citations (Scopus)


Spinocerebellar ataxia (SCA) is a hereditary disease characterized by central nervous system-related motor dysfunctions. Sleep disorders and frequent non-motor manifestations are commonly comorbid with SCA. To elucidate this relationship, we present three cases in a family that included multiple SCA type 2 patients with various sleep disorders. Complete physical examination, and genetic and imaging studies were performed. Anti-parkinsonism medications were prescribed after neurological examination. Clonazepam and/or quetiapine were administered for sleep disorders but failed to resolve insomnia and excessive daytime sleepiness (EDS). Based on DSM-5 criteria, all cases were diagnosed with depression. After treatment with serotonin-norepinephrine reuptake inhibitors and noradrenergic and specific serotonergic antidepressants, symptoms of insomnia and EDS, which are strongly associated with depression in SCA type 2 patients, improved significantly. It is crucial to recognize insomnia and EDS in neurodegenerative diseases, not only for earlier diagnosis, but also to improve quality of life.

Original languageEnglish
Pages (from-to)1059-1061
Number of pages3
JournalJournal of Clinical Sleep Medicine
Issue number7
Publication statusPublished - 2016



  • Depression
  • Excessive daytime sleepiness
  • Insomnia
  • Sleep disorders
  • Spinocerebellar ataxia

ASJC Scopus subject areas

  • Clinical Neurology
  • Pulmonary and Respiratory Medicine
  • Neurology

Cite this