Can Botulinum Injections Really Improve Sleep in Cervical Dystonia?

Botulinum neurotoxin injections can improve sleep in people with cervical dystonia. A recent study found that sleep quality became better after treatment. However, anxiety and depression did not improve much. So the injection helps sleep, but mood symptoms may still need separate care.

Why Sleep Problems Matter in Cervical Dystonia

Cervical dystonia is a painful movement disorder. It causes the neck muscles to contract without control. The head may twist or tilt. Pain stays. Stiffness too. Nights become difficult.

Many patients do not only struggle with muscle spasms. They also report poor sleep, anxiety, low mood, and reduced quality of life. These are called nonmotor symptoms. They quietly increase daily burden. Sometimes more than the visible muscle problem.

Doctors already use botulinum toxin injections to relax neck muscles. But does it help these hidden symptoms? That question needed clearer answers.

What the Study Looked At

The study followed 29 adults with cervical dystonia. The average age was around 61 years. All received intramuscular botulinum neurotoxin injections as part of routine care.

Sleep quality was measured using the Pittsburgh Sleep Quality Index. Before treatment, the average score was 10.1. After injection, it dropped to 7.41. Lower scores mean better sleep. The difference was statistically significant. That matters.

This shows sleep improved in a meaningful way. Not perfect sleep. But better.

How Much Did Sleep Improve?

The average change was 2.65 points on the sleep scale. That may sound small. Yet for someone waking up multiple times at night, even slight improvement feels big.

Patients likely slept deeper. Maybe fewer awakenings. Less discomfort from neck spasms during the night. When muscles relax, the body rests easier. That part seems logical.

The results suggest sleep may respond faster than other symptoms after injection. At least in the short term.

What About Anxiety and Depression?

Mood symptoms were also measured. Researchers used the Beck Depression Inventory II and Beck Anxiety Inventory II. Anxiety scores dropped slightly, from 13.5 to 12.52. Depression scores hardly changed. There was no statistically significant improvement.

That means botulinum toxin did not strongly affect emotional symptoms in this group.

Why? Possibly because anxiety and depression are complex. They are not only caused by muscle spasms. Brain chemistry, stress, long-term coping patterns, all play a role.

In simple words, relaxing neck muscles does not automatically fix mental health.

Quality of Life Still Needs Attention

Quality of life was assessed using EuroQol 5 dimensions. The study suggests that while sleep may improve, psychiatric symptoms may require additional treatment. Therapy. Medication. Counseling. Maybe a combined plan works better.

The research was published in Acta Neurologica Belgica in 2026. It was a small cohort study, not a large randomized trial. So results should be read carefully. Still, it adds useful insight.

What This Means for Patients

If you live with cervical dystonia, botulinum neurotoxin injections remain an important treatment for muscle symptoms. Now there is evidence that sleep might also get better. That alone can change daily life. Better sleep improves energy, focus, and pain tolerance.

But if anxiety or depression continue, separate support is important. Mental health care should not be ignored. Movement disorders affect the whole person, not just muscles.

In short, botulinum injections can help you sleep better if you have cervical dystonia. They may not lift mood symptoms significantly. A combined treatment approach probably gives the best outcome. More research will tell us more, but this finding already offers some quiet hope.