To explore the sleep disorders in patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis.

A total of 12 patients with anti-NMDAR encephalitis admitted to the outpatient department and inpatient department of Wuhan General Hospital of the Yangtze River Shipping in the recovery period were included. Twelve age- and sex-matched healthy participants were included as controls. All people were evaluated in body mass index (BMI) and video-polysomnography (VPSG). Data were compared between the two groups, including the total sleep time, total sleep efficiency, sleep latency, non-rapid eye movement (NREM) sleep N1 period, NREM sleep N2 period, NREM sleep N 3 to 4 period, REM sleep, number of cases of blurred arousals, periodic limb movements, AHI, and LSaO₂. The sleep status of patients with anti-NMDAR encephalitis at acute and recovery stages were evaluated.

The sleep structure of the patients with anti-NMDAR encephalitis did not change during recovery. Four patients showed blurred arousal on V-PSG, compared with healthy controls. The number of cases of blurred arousals had a statistical difference between the two groups (P=0.047). In the acute stage, 7 cases (58.3%) showed insomnia; while during the recovery stage, 6 cases (50.0%) had hypersomnia, and only 2 cases (16.7%) showed insomnia.

Sleep disturbances are frequent in patients with anti-NMDAR encephalitis. They show a temporal pattern, predominantly insomnia at onset and hypersomnia during recovery, and can occur with confusional arousals during NREM sleep.