Abstract
The aim of the present study was to evaluate the correlation between the end of an Oxford sleep resistance (OSLER) test session and a neurophysiological marker of sleep onset in Parkinson’s disease (PD) patients. Single center study was conducted in PD patients with excessive daytime sleepiness [Epworth sleepiness scale (ESS) >9]. The OSLER test was conducted with a concomitant electroencephalography (EEG), electromyography (mentalis), right and left electroculogram, and video monitoring. Neurophysiological (NP) sleep onset was defined according to AASM criteria (2005). Five PD patients with mean ESS of 14 (10–16) were included. OSLER test duration was shorter than 40 min in all patients (mean duration 20 min and 39 s). No patient fulfilled neurophysiological criteria to sleep onset at the time of OSLER test termination. In 13 OSLER sessions that ended before 40 min, eight had microsleeps in the last 30 s before the end of the test. NP monitoring showed signs of sleepiness in all patients. In PD patients, the early termination of an OSLER test session may not correspond to NP criteria of sleep onset. However, in all PD patients with abnormal OSLER results, there were EEG signs of sleepiness, which do not exclude the potential utility of OSLER test to evaluate the risk of falling asleep.
Highlights
It is well established that excessive daytime sleepiness (EDS) in Parkinson’s disease (PD) significantly interferes with the patient’s quality of life and constitutes an important risk factor for accidents [1, 2]
None of the patients fulfilled neurophysiological criteria of sleep onset in the end of Oxford sleep resistance (OSLER) test, we found that in 13 of the 19 OSLER sessions that ended before 40 min, 8 had microsleeps in the last 30 s before the end of OSLER test (Table 4)
The moment when patients stop pressing the switch for 21 s is supposed to represent sleep onset, and previous studies in non-PD populations have found that the OSLER test is capable of discriminating between sleepy and normal individuals without overlap [17]
Summary
It is well established that excessive daytime sleepiness (EDS) in Parkinson’s disease (PD) significantly interferes with the patient’s quality of life and constitutes an important risk factor for accidents [1, 2]. Several sleep scales have been used to evaluate PD sleep disorders, but only a small number has been assessed in a PD population [3, 5,6,7,8,9,10,11,12,13]. The International Parkinson and Movement Disorder Society recommends the Epworth sleepiness scale (ESS) [5] for use in PD for daytime sleepiness based on a review of the validity and clinimetric characteristics of all available sleep scales that have been applied to PD patients [13]. Sleepiness scales as the OSLER test in Parkinson’s disease
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