Sleep difficulties in Parkinson’s disease

Abstract

Introduction Insomnia is often complained by patients with Parkinson’s disease (PD). We studied occurrence of different complaints of insomnia, fatigue and sleepiness. Materials and methods The base populations consisted of 1447 patients with Parkinson’s disease. A structured questionnaire was sent. 649 subjects were included (55.7% men). Mean age was 68.1 y (SD 8.5). Average duration of PD was 5.9 y (SD 4.9). The questions were derived from the Basic Nordic Sleep Questionnaire. Results Occurrence of complaints on at least three nights/days per week were: difficulties falling asleep 16.6%, nocturnal awakenings 77.5%, early morning awakenings 37.8%, fatigue 43.4%, tiredness 52%, sleepiness 44.4%, snoring 38.8%, nocturnal breathing pauses (apnea) noted by others 6.8%, bruxism 2.9%, waking up to urinate at least once at night 70.3%. Of all 11.7% woke up at least thrice and 41.1% woke up at least twice per night to urinate. Altogether 47.5% complained of chronic insomnia lasting for at least one month. Using the Rimon Depression Scale 24.8% were depressive and using the WHO-5 scale (WHO-5 10 in 30.5% of the responders. Previous restless legs syndrome had been diagnosed in 5% of all but 17% fulfilled the IRLS criteria for RLS. Conclusion The most common sleep complaints are nocturnal awakenings and nocturia while bruxism and difficulties falling asleep were less frequent. RLS had been rarely diagnosed despite of the complaints. Acknowledgements This study was supported by the Finnish Parkinson Foundation.