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Abstract
ObjectivesParkinson's disease (PD) is a multisystem movement disorder associated with sleep disturbance and depression. Sleep disturbances and depression severity share a bidirectional association. This association may be greater in individuals who are more vulnerable to the deleterious consequences of sleep disturbance and depression severity. We investigated whether the association between sleep disturbances and depression severity is greater in patients with PD than in matched controls (MC).Materials and MethodsThe study sample (N = 98) included 50 patients with idiopathic PD and 48 age‐, race‐, sex‐, and education‐matched controls. Sleep disturbances were assessed using self‐reported total sleep time (TST) on the Pittsburgh Sleep Quality Index, the sleep item on the Beck Depression Inventory, 2nd ed. (BDI‐II), and the Insomnia Severity Index total score. Depression severity was assessed using the BDI‐II total score, excluding the sleep item. Spearman's correlations, chi‐squared tests, and multiple regression were used to assess associations between sleep disturbances and depression severity in PD and MC. Fisher's Z transformation was used to test whether the association between sleep disturbances and depression severity was stronger in patients with PD.ResultsShorter TST, sleeping less than usual, and insomnia severity were associated with depression severity in the total sample, r s(94) = −0.35, p = .001; r s(71) = 0.51, p < .001; r s(78) = −0.47, p < .001; r s(98) = 0.46, p < .001, respectively. The association between shorter TST and depression severity was greater in patients with PD than it was in MC, p < .05.ConclusionShort TST may be an important marker, predictor, or consequence of depression severity in patients with Parkinson's disease.
Highlights
Idiopathic Parkinson’s disease (PD) is one of the most common neurodegenerative disorders, second only to Alzheimer’s disease.Historically viewed as a motor disorder, PD is a complex, multisystem disorder associated with nonmotor symptoms including sleep changes and depression
We explored the associations between different types of self- reported sleep disturbances and depression symptoms in a sample of patients with PD and in matched controls (MC)
Additional exclusion criteria related to sleep included (i) self or bed partner report of symptoms on the Pittsburgh Sleep Quality Index (PSQI), diagnosis, or treatment for obstructive sleep apnea (OSA), restless leg syndrome (RLS), or periodic limb movement disorder (PLMD) or (ii) lack of bed partner who was able to document the absence of OSA, RLS, and PLMD
Summary
Idiopathic Parkinson’s disease (PD) is one of the most common neurodegenerative disorders, second only to Alzheimer’s disease.Historically viewed as a motor disorder, PD is a complex, multisystem disorder associated with nonmotor symptoms including sleep changes and depression. Depression symptoms, predominantly mild, are highly prevalent in patients with PD, affecting 14%–35% of patients (Reijnders, Ehrt, Weber, Aarsland, & Leentjens, 2008; Rutten et al, 2017). Sleep disturbances including altered TST and insomnia are associated with depression symptoms in PD (Avidan et al, 2013; Borek, Kohn, & Friedman, 2006; Gjerstad, Wentzel-Larsen, Aarsland, & Larsen, 2007; Goetz, Wilson, Tanner, & Garron, 1987; Kumar, Bhatia, & Behari, 2002; Margis, Donis, Schonwald, & Rieder, 2010; Naismith, Hickie, & Lewis, 2010). Short TST and insomnia are overlapping but separate sleep problems that may be associated with depression through different pathophysiological mechanisms. Investigating the association between different types of sleep disturbances and depression severity in patients with PD may help elucidate their pathophysiology
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