While hypersomnolence characterize the final stage of African trypanosomiasis, sleep disturbances can be identified earlier in the course of the disease.
Features of sleep disturbances in African trypanosomiasis:
(1) reversal of sleep-wake cycle (daytime somnolence; nighttime insomnia)
(2) short sleep episodes that occur equally by day and by night
(3) narcoleptic crises
(4) uncontrollable urge to sleep in terminal phase
Polysomnography shows changes in sleep structure including frequent sleep onset rapid eye movement periods (SOREMPs).
Significance of sleep disturbances in African trypanosomiasis:
(1) The onset correlates with the encephalopathy.
(2) The severity of the sleep disturbance is proportionate to the severity of the illness.
(3) The sleep disturbance reverses with successful therapy.
(4) Re-appearance is associated with clinical relapse.
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