HYPERSOMNIA IN PARKINSON’S DISEASE

Abstract

OBJECTIVES: The clinical relevance of hypersomnia in patients with Parkinson’s disease (PD) is underestimated. It manifests with constant excessive daytime somnolence and short-term sleep attacks. The relation of hypersomnia with insomnia and the impact of hypersomnia on the quality of life of are not studied. PURPOSE OF STUDY: to assess the prevalence and demographic outcomes of hypersomnia, its relation with motor, neuropsychological disturbances and its impact on quality of life of patients. PATIENTS AND METHODS: One hundred and six (106) patients with Parkinson’s disease without dementia were examined. The mean age was 63,78±0,6 years, stage of Parkinson’s disease was 2,6±0,22,46±0,7 according Hoen and Yahr scale, PD duration consisted 6,3±3,2 years. We used the following tests and scales for assessment of motor and neuropsychiatric functions: UPDRS, Beck’s depression Inventory, the Spielberger State-Trait Anxiety Inventory, sleep scales, the Epworth sleepiness scale, fatigue scale (FSPD-16), cognitive functions scale in PD, theLilleapathy rating scale, and quality of life questionnaire in PD (QoLPD-39). Statistical analysis was performed using Student’s t-test and Pearson’s correlation matrix. RESULTS: Hyperomnia was detected in 44% of patients. Permanent excessive daytime somnolence without sleep attacks was revealed in 16 (15%) patients. Sleep attacks without preceding somnolence or with imperative from 1 to 3 minutes episodes of somnolence was seen in 15 (14%) patients. In 16 (15%) patients we revealed combination of permanent excessive somnolence with sleep attacks. Men more frequently had excessive daytime somnolence. We revealed correlation between frequency and duration of sleep attacks and severity of PD (p<0,05). Patients with sleep attacks had more difficulties in everyday activity, had more severe symptoms of movement disorders (speech disorders, fallings, and gait freezing) and sleep disturbances. Positive correlation was revealed between hypersomnia and depression, between hypersomnia and attention failure and negative correlation between hypersomnia and reactive anxiety. Patients with excessive somnolence have been treated with dophaminergic drugs for longer time period than the patients without somnolence. Hypersomnia was shown to impact negatively on cognitive and communicative aspects of quality of life. CONCLUSIONS: the facts of clinical and pathophysiological heterogeneity of hypersomnia are received. Hypersomnia decreases the quality of life of patients with PD, especially its cognitive and communicative aspects.