Lyme disease sleep disorders

Patients with post-treatment Lyme disease syndrome (PTLDS) may experience sleep disturbances, according to a study by Johns Hopkins University School of Medicine. Researchers found, “PTLDS participants reported significantly worse global sleep and sleep disturbance scores and worse fatigue, functional impact, and more cognitive-affective depressive symptoms compared to poor-sleeping controls.” [1]

Dr. Robert Bransfield, a New Jersey-based psychiatrist who specializes in the diagnosis and treatment of tick-borne illnesses, has seen a broad range of sleep disorders in Lyme disease patients treated at his practice. He describes the various sleep disorders in the article “Neuropsychiatric Lyme Borreliosis: An Overview with a Focus on a Specialty Psychiatrist’s Clinical Practice.” [2]

The patients experienced:

• Non-restorative sleep
• Early insomnia
• Middle of the night insomnia
• Early morning insomnia
• Excessive daytime sleepiness
• Loss or reversal of circadian rhythm
• Restless leg
• Paroxysmal nocturnal limb movements
• Sleep apnea (central and/or obstructive)
• Sleep paralysis
• Hypnagogic hallucinations
• Sleep attacks
• Cataplexy
• Narcolepsy

The combination of “non-restorative sleep and chronic unremitting stress appear to play a significant role in disease progression,” explains Bransfield.

“Both non-restorative sleep and the chronic unremitting stress seen in these chronically ill patients contribute to disease perpetuation and progression and are associated with fatigue, cognitive impairments, decreased regenerative functioning, compromised immunity, decreased resistance to infectious disease and neurodegenerative processes,” he writes.

Editor’s note: I have also found that Lyme disease patients can suffer from a broad range of sleep disorders. However, it can be difficult to determine whether Lyme disease or a comorbidity is responsible for the sleep disturbance. I have found that antibiotic treatment often improves sleep disorder symptoms.