Abstract
ObjectiveTo study the relationship between sleep disturbances and symptoms in patients with Parkinson’s disease (PD).MethodsThe Parkinson’s Disease Sleep Scale-Chinese Version (PDSS-CV) was used to evaluate the sleep disturbances of PD patients in a cross sectional study. The Unified Parkinson’s Disease Rating Scale (UPDRS) parts II-IV, and the Hoehn & Yahr (H&Y) stage were used to determine the level of motor function in PD and the severity of PD. The Spearman correlation and a multiple regression analysis were used to identify the relationship between sleep disturbances and symptoms of PD. The quantities derived from the UPDRS and the H&Y stage and disease duration were compared between groups of patients either with or without sleep disturbances identified by the PDSS. This study was conducted from December 2011 to March 2012 at the First Affiliated Hospital of Sun Yat-sen University, in Guangzhou.ResultsA total of 136 PD patients were included in this study. The overall total PDSS score in PD patients was 107.58 ± 23.35 points (range: 30–146). There were significant differences in the disease duration, the H&Y stage, and the UPDRS section subscores between groups of patients either with or without sleep disturbances (Kruskal-Wallis Test, p <0.05). There were significant negative correlations between PDSS scores and the UPDRS subscores, the H&Y stage and the disease duration (Spearman correlation, p < 0.05). The multiple regression analysis indicated that sleep disturbances identified by the PDSS were only associated with daily life activity, tremor intensity and clinical fluctuation (R2 = 0.22, F(3,132) = 12.4, p < 0.001). The correlations were also significant when the contribution of the other two factors was excluded using partial correlations.ConclusionsThe level of daily life activity and the occurrences of tremor and clinical fluctuation are likely to be important factors that lead to PD patients’ sleep disturbances. This study may elucidate an important clue for the relationship between sleep disturbances and PD symptoms.
Highlights
Parkinson’s disease (PD) is the second most common neurodegenerative disorder in the world
The RECOVER trial showed that treatment with rotigotine in PD patients resulted in significant benefits in control of both motor function and nocturnal sleep disturbances [4]
The prevalence of sleep disturbances identified by Parkinson’s Disease Sleep Scale (PDSS) increased with the disease severity (Table 1): 3 out of 28 patients (10.7%) when Hoehn & Yahr (H&Y) = 1; 8 out of 68 patients (11.8%) when H&Y = 2; 11 out of 31 patients (35.5%) when H&Y = 3; 4 out of 9 patients (44.4%) when H&Y = 4
Summary
Parkinson’s disease (PD) is the second most common neurodegenerative disorder in the world. Neuropsychiatric symptoms, especially depression, nighttime sleep disorders, motor fluctuations, and unpredictable fluctuations are the variables that most affect the QoL of patients with PD [3]. Recent studies demonstrated that individual suffering from rapid eye movement (REM) sleep behavior disorder (RBD) carry a high specific risk (up to 80%) for developing a neurodegenerative disorder of α- synucleinopathy (e.g. Parkinson’s disease, dementia with Lewy bodies and multiple system atrophy) within 10–20 years [10]. These results show that there are some associations between PD motor symptoms and sleep disturbances. The identification of sleep disturbances and impaired motor function or complications of therapy will help us to improve our treatment approach to achieve the main goal of improving the QoL of our patients
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