Fatigue, Sleepiness and Sleep Issues in Patients with Dystonia (P01.224)

Abstract

Objective: To determine the prevalence of fatigue, excessive daytime somnolence (EDS) and sleep issues in patients with dystonia and examine its impact on quality of life (QOL). Background Dystonia is a movement disorder that is primarily described by its motor manifestations but is also associated with several non-motor symptoms. Prior research suggests tiredness and energy as important determinants of QOL independent of mood. However, there is a lack of specific data on fatigue, EDS and sleep disorders in dystonia determined using standardized questionnaires. Design/Methods: We administered the following scales to ninety-one patients with primary and secondary dystonia followed at a Movement Disorders clinic: the Fatigue Severity Scale, Epworth Sleepiness Scale, and Parkinson9s Disease Sleep Scale to measure fatigue, EDS and sleep issues respectively; Short Form 36 Health Survey questionnaire to measure QOL, Beck Depression Inventory for depression, and the Unified Dystonia Rating Scale to assess dystonia severity. Results: The mean age of the patients was 60 +/- 17 years, mean duration of dystonia was 7.5 +/- 8 years and dystonia types were focal (74%), segmental (21%) and generalized (5%). Patients with dystonia showed high rates of clinically significant fatigue (46%), EDS (27%) and sleep issues (26%). These prevalence rates did not vary significantly based upon dystonia type, dystonia severity or body parts affected. Depression showed strong correlations with fatigue (r = +0.47, p = 0.0003), EDS (r = +0.35, p = 0.003) and sleep issues (r = -0.40, p = 0.0007). While EDS, sleep issues and fatigue were all associated with reduced QOL, only fatigue remained correlated with QOL when controlling for depression (p = 0.04). Conclusions: This study demonstrates fatigue, EDS and sleep issues are common non-motor manifestations of dystonia that are associated with depression and adversely impact QOL. However amongst the three factors, fatigue affects QOL independent of depression. Disclosure: Dr. Heese has nothing to disclose. Dr. Wagle-Shukla has nothing to disclose. Dr. Okun has received personal compensation for activities with National Parkinson Foundation, Ask the Expert, and Neuropace Devices. Dr. Okun has received research support from the Michael J. Fox Foundation, the National Parkinson Foundation, the Parkinson Alliance and the National Institutes of Health. Dr. Kluger has received research support from Teva Neuroscience.