Activity—Rest Rhythm Abnormalities in Parkinson's Disease Patients are Related to Dopaminergic Therapy

Abstract

ABSTRACTObjectives: To compare going to bed, waking-up, and immobility onset and offset times in Parkinson's disease (PD) patients receiving levodopa and/or dopamine agonists (i.e., dopaminergic therapy or DT) with “de novo” patients and healthy controls and to correlate these parameters with self-reported sleep disturbances. Methods: Fifteen “de novo” and 60 PD patients on DT were included in the study. Twenty-three subjects without history of sleep complaints and similar age and sex distributions as the PD patients served as controls. Going to bed and waking-up times were registered in 7-day sleep logs. Nocturnal immobility onset and offset times were measured using actigraphy. Sleep disorders were assessed applying the PD sleep scale (PDSS). Results: Patients on DT showed earlier waking-up and immobility offset times (40 min) compared with controls and “de novo” patients. Multivariable regression analysis showed that DT but not Hoehn & Yahr score was a significant and independent predictor of early awakening time (OR == 4.0, 95%% CI == 1.15–14.13). Patients manifesting more frequent nighttime psychotic symptoms and more frequent daytime somnolence showed earlier going to bed and waking-up times. Conclusions: Results suggest that activity–rest rhythm alteration in PD may be a consequence of DT but not of disease stage. Altered sleep cycles correlated with diurnal somnolence and nocturnal psychosis.