The association of dopamine agonists with daytime sleepiness, sleep problems and quality of life in patients with Parkinson's disease

Background: Early morning off (EMO) refers to off-states in the morning in people diagnosed with Parkinson's disease (PwPD). This study determined the clinical manifestations of EMO and the association with nocturnal sleep problems and quality of life (QOL) in Chinese PwPD.Methods: In this multicenter, observational, cross-sectional study, data concerning the clinical manifestations of EMO were collected from PwPD in Shanghai by questionnaire. The stepwise logistic regression was performed to analyze the potential risk factors, as well as whether EMO was an independent risk factor for functional dependency in daily life. The mediation analyses were conducted to evaluate whether nocturnal sleep problems might mediate the association between EMO and the QOL.Results: Among the 454 subjects evaluated, EMO occurred in 39.43% of PwPD across all disease stages. The prevalence of EMO increased as the Hoehn and Yahr stage increased and was observed in 35.60% of patients in stages 1–2.5 and 48.85% of patients in stages 3–5. EMO was associated with non-motor symptoms (NMSs). The predominant NMSs associated with EMO were nocturnal sleep problems (98.90%), mood/cognition impairment (93.90%), decreased attention/memory (91.60%), gastrointestinal symptoms (91.60%), and urinary urgency (90.50%). The QOL of PwPD with EMO was significantly reduced (P < 0.001). Moreover, nocturnal sleep problems might partially mediate this relationship (indirect effect: β = 13.458, 95% boot CI: 6.436, 22.042).Conclusion: PwPD have EMO throughout all stages of the disease. Patients with EMO have severe motor symptoms and NMSs. EMO decreases the QOL in PwPD and this relationship is partially mediated by nocturnal sleep problems. In light of these findings, it is suggested that recognition and appropriate treatment of EMO and nocturnal sleep problems could improve the management of PwPD.

Download Full-text

Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson’s Disease

Journal of Geriatric Psychiatry and Neurology ◽

10.1177/0891988720964250 ◽

2020 ◽

pp. 089198872096425

Author(s):

Diego Santos-García ◽

E. Suárez Castro ◽

T. de Deus Fonticoba ◽

M. J. Feal Panceiras ◽

J. G. Muñoz Enriquez ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Problems ◽

Cross Sectional Study ◽

Motor Symptoms ◽

Levodopa Dose ◽

Cross Sectional ◽

Non Motor Symptoms

Introduction: The aim of the present study was to examine the frequency of self-reported sleep problems and their associated factors in a large cohort of PD patients. Methods: PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort were included in this cross-sectional study. Sleep problems were assessed by the Spanish version of the Parkinson’s disease Sleep Scale version 1 (PDSS-1). An overall score below 82 or a score below 5 on at least 1 item was defined as sleep problems. Results: The frequency of sleep problems was nearly double in PD patients compared to controls: 65.8% (448/681) vs 33.5% (65/206) (p < 0.0001). Mean total PDSS score was lower in PD patients than controls: 114.9 ± 28.8 vs 132.8 ± 16.3 (p < 0.0001). Quality of life (QoL) was worse in PD patients with sleep problems compared to those without: PDQ-39SI, 19.3 ± 14 vs 13 ± 11.6 (p < 0.0001); EUROHIS-QoL8, 3.7 ± 0.5 vs 3.9 ± 0.5 (p < 0.0001). Non-motor symptoms burden (NMSS; OR = 1.029; 95%CI 1.015–1.043; p < 0.0001) and impulse control behaviors (QUIP-RS; OR = 1.054; 95%CI 1.009–1.101; p = 0.018) were associated with sleep problems after adjustment for age, gender, disease duration, daily equivalent levodopa dose, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments. Conclusion: Sleep problems were frequent in PD patients and were related to both a worse QoL and a greater non-motor symptoms burden in PD. These findings call for increased awareness of sleep problems in PD patients.

Download Full-text

Quality of Life in Newly Diagnosed Patients With Parkin-Related Parkinson's Disease

Frontiers in Neurology ◽

10.3389/fneur.2020.580910 ◽

2020 ◽

Vol 11 ◽

Author(s):

Xin-Yue Zhou ◽

Feng-Tao Liu ◽

Chen Chen ◽

Su-Shan Luo ◽

Jue Zhao ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Disease Duration ◽

Motor Symptoms ◽

Newly Diagnosed ◽

Non Motor Symptoms

Introduction: Mutations in the Parkin gene are the most common cause of autosomal recessive early-onset Parkinson's disease (PD). However, little is known about the quality of life (QoL) in Parkin-related PD. Here, we investigated the patterns of QoL in newly diagnosed Parkin-related PD patients.Methods: Newly diagnosed PD patients (diagnosis made within 12 months) who had an age of onset (AOO) below 40 and underwent a PD-related genetic testing, were recruited (n = 148). Among them, 24 patients carried bi-allelic variants in Parkin (PD-Parkin) and 24 patients did not have any known causative PD mutations, or risk variants (GU-EOPD). The clinical materials, relevant factors and determinants of QoL were analyzed.Results: PD-Parkin patients had a younger AOO (p = 0.003) and longer disease duration (p = 0.005). After adjustment for AOO and disease duration, more dystonia (p = 0.034), and worse scores of non-motor symptoms including Beck depression inventory (BDI, p = 0.035), Epworth sleepiness scale (ESS, p = 0.044), and subdomains of depression/anxiety (p = 0.015) and sleep disorders (p = 0.005) in Non-motor symptoms questionnaire, were found in PD-Parkin comparing with GU-EOPD. PD-Parkin patients had poorer QoL (adjusted p = 0.045), especially in the mobility (adjusted p = 0.025), emotional well-being (adjusted p = 0.015) and bodily discomfort dimensions (adjusted p = 0.016). BDI scores (p = 0.005) and ESS scores (p = 0.047) were significant determinants of QoL in PD-Parkin.Conclusion: Newly diagnosed PD-Parkin patients showed worse QoL. More depression and excessive daytime sleepiness predicted worse QoL. For clinicians, management of depression and excessive daytime sleepiness is suggested to better improve QoL in patients with Parkin mutations.

Download Full-text

Selegiline Improves Excessive Daytime Sleepiness in Parkinson’s Disease: An Open Trial

10.21203/rs.3.rs-708038/v1 ◽

2021 ◽

Author(s):

Jinru Zhang ◽

Ju-ping Chen ◽

Jia Li ◽

Jian Li ◽

Hong Miao ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Motor Fluctuation ◽

Life Questionnaire ◽

Open Label ◽

Multi Center Study

Abstract Excessive daytime sleepiness (EDS) is common in Parkinson’s disease (PD) and may respond to dopaminergic therapies. The aim of this open-label trial was to assess the efficacy and safety of selegiline as a treatment for EDS in PD patients. In this multi-center study, 141 PD subjects were enrolled between December 2019 and October 2020, and 121 patients completed the 8-week study. Selegiline was administered at 5 mg/day in the first week and was increased to 10 mg per day during the following weeks. EDS was evaluated using the Epworth Sleepiness Scale (ESS) at baseline, week 3, and week 8. Changes in motor complications, sleep quality, and quality of life were also assessed in patients with PD. As primary outcomes, ESS scores decreased significantly in PD patients who received selegiline for 8 weeks (P < 0.001). As secondary outcomes, the scores of Parkinson's disease sleep scale (PDSS) and Parkinson’s disease quality of life questionnaire 39 (PDQ-39) also improved after the treatment. The severity of motor fluctuation improved (P=0.037), while the percentage of patients with dyskinesia and the severity of dyskinesia did not increase significantly compared with baseline. Participants treated with selegiline showed an improvement in EDS and good tolerance of the drug. This study demonstrated the efficacy of selegiline for the treatment of daytime sleepiness in PD patients.Trial registration: clinicaltrials, NCT04870372. Registered 5 May 2021 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009J06&selectaction=Edit&uid=U00026CP&ts=2&cx=ruz8uy.

Download Full-text

3.506 Impact of sleep problems on health-related quality of life of Parkinson's disease patients and their caregivers

Parkinsonism & Related Disorders ◽

10.1016/s1353-8020(08)70935-0 ◽

2007 ◽

Vol 13 ◽

pp. S189

Author(s):

P. Martinez-Martin ◽

M. Visser ◽

C. Rodriguez-Blazquez ◽

J. Marinus ◽

B. Frades ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Problems ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Download Full-text

Factors related to sleep disturbances for individuals with Parkinson’s disease: a regional perspective

International Psychogeriatrics ◽

10.1017/s1041610219001212 ◽

2019 ◽

Vol 32 (7) ◽

pp. 827-838

Author(s):

Rachael Wade ◽

Nancy A. Pachana ◽

George Mellick ◽

Nadeeka Dissanayaka

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Disturbances ◽

Sleep Problems ◽

Cross Sectional ◽

Sleep Dysfunction ◽

Cross Sectional Design ◽

Positive Correlations

ABSTRACTObjectives:Sleep disturbances negatively impact the quality of life of patients with Parkinson’s disease (PD). While persons living in regional areas are at higher risk of PD, PD is poorly managed in regional communities. This study examined factors associated with sleep problems in PD in a regional context.Design:A mixed-methods cross-sectional design was used.Participants:Patients with PD were recruited from the Queensland Parkinson’s Project database.Measurements:Those who agreed to participate were sent a questionnaire assessing aspects of sleep, depression, anxiety, quality of life, and PD severity. Qualitative information was also gathered. Correlations between variables were examined; thematic analyses were performed for qualitative data.Results:All participants (n = 49) reported sleep disturbances, with 73% (n = 36) reporting sleep disturbance to be problematic. Global sleep dysfunction positively correlated with daytime napping (r = .34, p = .01), watching the clock when unable to sleep (r = .38, p = <.01), staying in bed when unable to sleep (r = .43, p = <.01), and going to bed hungry (r = .31, p = .03) and negatively correlated with daytime exercise (r = -.32, p = .02). Positive correlations were observed between global sleep dysfunction and depression (r = .55, p = <.01), anxiety (r = .31, p = .04), and dysfunctional sleep beliefs (r = .39, p = <.01).Conclusion:There is a clear need for identifying factors related to sleep disturbances in PD for effective management.

Download Full-text