Abstract
Parkinson's disease (PD) is associated with sleep complaints as excessive daytime sleepiness (EDS) and several factors have been implicated in the genesis of these complaints. Objective. To correlate the subjective perception of EDS with variables as the severity of the motor symptoms, medications, and the presence of depressive symptoms. Materials and Methods. A cross-sectional study, using specific scales as Epworth sleepiness scale (ESS), Beck depression inventory (iBeck) and Hoehn and Yahr (HY), in 42 patients with PD. Results. The patients had a mean age of 61.2 ± 11.3 years and mean disease duration of 4.96 ± 3.3 years. The mean ESS was 7.5 ± 4.7 and 28.6% of patients reached a score of abnormally high value (>10). There was no association with gender, disease duration, and dopamine agonists. Patients with EDS used larger amounts of levodopa (366.7 ± 228.0 versus 460.4 ± 332.25 mg, P = 0.038), but those who had an iBeck >20 reached lower values of ESS than the others (5.9 ± 4.1 versus 9.3 ± 4.8, P = 0.03). Conclusions. EDS was common in PD patients, being related to levodopa intake. Presence of depressed mood may influence the final results of self-assessment scales for sleep disorders.
Highlights
Parkinson’s disease (PD) is a leading progressive neurodegenerative disease, with prevalence estimated 1-2% of the population above 55 years
The objective of this study is to evaluate, through a subjective measure of the level of daytime sleepiness, the characteristics and determinants of Excessive daytime sleepiness (EDS) in patients with PD, including the influence of depressive symptoms
Of a total of 65 patients interviewed, seven were excluded because they did not meet the diagnostic criteria for idiopathic PD and sixteen, because they had cognitive impairment that would hinder the completion of the scales and questionnaire
Summary
Parkinson’s disease (PD) is a leading progressive neurodegenerative disease, with prevalence estimated 1-2% of the population above 55 years. Sleep-related complaints are frequent in this population and, in some cases, may be the initial manifestation of the disease. A population study, which evaluated 245 patients with Parkinson’s disease, showed that more than two-thirds of them had complaints about sleep disturbances and complaints of the same type are found in 46% of diabetic patients and 33% of control patients [2]. Clinical evidence support the hypothesis of EDS being a particular symptom of PD and its potential association with disease progression [2,3,4]. The EDS can arise as a secondary symptom nighttime sleep deprivation or other sleep disorders such as sleep apnea (present in 20–30% of PD patients). There are reports that the dopamine agonists cause drowsiness as a class effect [9], in many studies, the main predictive factor is the total amount of the dose dopamine [10, 11]
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