scholarly journals Sleep disturbance in movement disorders: insights, treatments and challenges

2021 ◽  
pp. jnnp-2020-325546
Author(s):  
Grace A Bailey ◽  
Emily K Hubbard ◽  
Alfonso Fasano ◽  
Marina AJ Tijssen ◽  
Timothy Lynch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Movement Disorder ◽  
Movement Disorders ◽  
Motor Symptom ◽  
Poor Sleep ◽  
Motor Symptoms ◽  
Abnormal Sleep

Sleep and circadian rhythm disturbances are central features of many movement disorders, exacerbating motor and non-motor symptoms and impairing quality of life. Understanding these disturbances to sleep is clinically important and may further our understanding of the underlying movement disorder. This review evaluates the current anatomical and neurochemical understanding of normal sleep and the recognised primary sleep disorders. In addition, we undertook a systematic review of the evidence for disruption to sleep across multiple movement disorders. Rapid eye movement sleep behaviour disorder has emerged as the most reliable prodromal biomarker for the alpha synucleinopathies, including Parkinson’s disease and multiple system atrophy, often preceding motor symptom onset by several years. Abnormal sleep has also been described for many other movement disorders, but further evidence is needed to determine whether this is a primary or secondary phenotypic component of the underlying condition. Medication used in the treatment of motor symptoms also affects sleep and can aggravate or cause certain sleep disorders. Within the context of movement disorders, there is also some suggestion of a shared underlying mechanism for motor and sleep pathophysiology, with evidence implicating thalamic and brainstem structures and monoaminergic neurotransmission. This review highlights the need for an understanding of normal and abnormal sleep within the movement disorder clinic, an ability to screen for specific causes of poor sleep and to treat sleep disturbance to improve quality of life. Key sleep disorders also act as important biomarkers and have implications in diagnosis, prognosis and the development of future therapies.

Motor Symptom Asymmetry Predicts Non-motor Outcome and Quality of Life Following STN DBS in Parkinson's Disease

2021 ◽  
Author(s):  
Julie Péron ◽  
Philippe Voruz ◽  
Jordan Pierce ◽  
Kévin Ahrweiller ◽  
Claire Haegelen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Symptom ◽  
Control Group ◽  
Motor Symptoms ◽  
Healthy Control ◽  
The Impact ◽  
Stn Dbs

Abstract Risk factors for long-term non-motor disorders and quality of life following subthalamic nucleus deep-brain stimulation (STN DBS) have not yet been fully identified. In the present study, we investigated the impact of motor symptom asymmetry in Parkinson’s disease.Data were extracted for 52 patients with Parkinson’s disease (half with left-sided motor symptoms and half with right-sided ones) who underwent bilateral STN and a matched healthy control group. Performances for cognitive tests and neuropsychiatric and quality-of-life questionnaires at 12 months post-DBS were compared with a pre-DBS baseline. Results indicated a deterioration in cognitive performance post-DBS in patients with left-sided motor symptoms. Performances of patients with right-sided motor symptoms were maintained, except for a verbal executive task. These differential effects had an impact on patients’ quality of life. The results highlight the existence of two distinct cognitive profiles of Parkinson’s disease, depending on motor symptom asymmetry. This asymmetry is a potential risk factor for non-motor adverse effects following STN DBS.

Sleep Disturbance in Palliative Care

2018 ◽  
Author(s):  
Rebecca Burke ◽  
Sriram Yennurajalingam
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Sleep Disturbance ◽  
Poor Sleep ◽  
Primary Care Population ◽  
Nonrestorative Sleep ◽  
Falling Asleep ◽  
High Index Of Suspicion ◽  
Prevalent Symptom

Sleep disturbance is a persistent source of suffering in palliative care patients. Symptoms such as difficulty falling asleep, staying asleep, early awakening, or nonrestorative sleep are all indicative of sleep disorders. Poor sleep can have consequential effects on perception of pain, fatigue, mood, and quality of life. It is not only a prevalent symptom in the primary care population but also may in fact affect more than 60% of the palliative care population. In addition to the complexities of treatment, insomnia often serves as a red herring to alarm physicians of underlying conditions. Therefore, it is essential that palliative care physicians maintain a high index of suspicion for such confounding conditions as restless leg syndrome, sleep apnea, and delirium. This chapter highlights the intricacies of sleep disturbance and focuses on the most common patient presentations.

scholarly journals B-23 Non-Motor Symptom Profile in Parkinson’s Disease Patients and its impact on Quality of Life

2019 ◽  
Vol 34 (6) ◽  
pp. 969-969
Author(s):  
L Sabbah-Talasazan ◽  
J Miller ◽  
J Wertheimer
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disturbance ◽  
Motor Symptom ◽  
Age Cohorts ◽  
Cognitive Difficulties ◽  
Symptom Profile ◽  
The Impact

Abstract Objective Non-motor Symptoms (NMS) in Parkinson’s Disease (PD) are known to be diverse and may include cognitive, psychiatric and sleep disturbance, fatigue, and autonomic disorders (e.g., cardiovascular dysregulation, orthostatic hypotension, thermo-dysregulation, sexual dysfunction, urinary and bowel dyscontrol). The aim of this study was to define the NMS profile in a large sample of PD patients with and without Deep Brain Stimulation (DBS) and its impact on quality of life (QOL). Method Cross-sectional, survey-based research design was used. 1,164 individuals with PD participated in this survey: 275 participants who underwent DBS and 889 without DBS. Participants completed the Non-Motor Symptom Scale (NMSS) and answered questions assessing the impact of NMS on everyday life. Participants were divided into younger (ages 50-69) and older (ages 70+) age cohorts and disease duration cohorts with early stage ( < 6 years) and advanced stage (6-10 years; 11+ years) groups. Results 24 out of 31 NMS categories were experienced by more than 50% of the participants. Urination difficulty, fatigue, sleep, constipation, and cognitive difficulties were symptoms most frequently reported to adversely impact day-to-day living, and cognitive difficulties followed by sleep disturbance had the strongest impact to quality of life. Conclusions NMS burden drives quality of life for many individuals and has remained a relatively new frontier for exploration, at least in depth and scope as it relates to assessment and treatment of NMS. Management of NMS remains an unmet need for individuals with PD. Implications for neuropsychologists are discussed.

Sleep disorders in multiple sclerosis

2017 ◽  
Author(s):  
Luigi Ferini-Strambi ◽  
Sara Marelli
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
General Population ◽  
Sleep Disturbance ◽  
Sleep Disorders ◽  
Depression Symptoms ◽  
Appropriate Treatment ◽  
Immunological Factors ◽  
Clinical Awareness

Though often unrecognized, sleep disorders in MS are seen at higher frequency than the general population, and they may contribute to pain, fatigue and depression—symptoms commonly observed in MS patients. Since several immunological factors in serum have been implicated in the development of sleep disorders, and MS is proven to be characterized by immune abnormalities, the notion that MS and sleep disorders share a similar background seems reasonable. Investigation of sleep disorders in MS is important, especially considering that the treatment of sleep disturbance may contribute to a reduction in debilitating symptoms, such as fatigue. Thus, an increased clinical awareness and appropriate treatment of sleep disorders in the MS population may significantly improve the overall quality of life in these patients.

A Review of Sleep Concerns in Pediatric Sickle Cell Disease

2012 ◽  
Vol 08 (01) ◽  
pp. 83
Author(s):  
Lauren C Daniel ◽  
Lamia P Barakat ◽  
◽  
Keyword(s):  
Quality Of Life ◽  
Sickle Cell Disease ◽  
Health Outcomes ◽  
Ethnic Minority ◽  
Sleep Disorders ◽  
Sickle Cell ◽  
Poor Sleep ◽  
Minority Status ◽  
Cell Disease

Children with sickle cell disease (SCD) are at an increased risk of sleep disorders as compared with healthy children, possibly because of disease processes, pain, ethnic minority status, and living in an urban environment. Adequate sleep is an essential component of typical child development, mood-and-affect regulation, and health maintenance, but more research is needed to understand the contribution of sleep to health outcomes in children with SCD. SCD is a chronic disease that can be influenced by environmental, health, and behavioral factors. Understanding the impact of the disease on sleep is important to maximise the quality of life in these children. If SCD causes poor sleep quality, then children may be at risk of a host of developmental and psychosocial problems beyond those caused by the disease. Also, poor sleep may affect the disease course, thus exacerbating symptoms. In this article, prevalent sleep disorders in this population are reviewed, including sleep-disordered breathing, periodic limb movement disorder, restless legs syndrome, and nocturnal enuresis. Also, the contribution of the disease symptoms—such as pain, hypoxemia, and daytime tiredness and fatigue—to disrupted sleep are examined. Finally, the effects of sociodemographic factors, such as poverty and ethnic minority status, are described, as these contextual factors significantly impact sleep across several chronic conditions in pediatric patients. Frequent monitoring for sleep disruptions can be essential to improving health outcomes and quality of life in children with SCD.

Association among fatigue, sleep disorders and other clinical parameters in Parkinson’s disease

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
A Asano ◽  
N Asano ◽  
D Mota ◽  
I Gondim ◽  
F Aroxa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Clinical Parameters ◽  
Motor Symptoms ◽  
Nocturnal Sleep ◽  
Advanced Stages

Abstract Introduction Fatigue and sleep disorders are common in Parkinson disease (PD) patients. Fatigue is not always clinically recognized because of its subjective character manifested by feelings of extreme tiredness. These non-motor symptoms can occur from the early stages of the disease and tend to persist. Objectives To evaluate fatigue in patients with PD and the possible association with sleep disorders and other clinical parameters of the PD; and to evaluate the impact of fatigue on quality of life Methodology A cross-sectional study with 123 patients with PD was implemented. The following instruments were used: Mini Mental State Examination, the Hoehn-Yarh Scale, Beck Depression Inventory, Parkinson’s Disease Quality of Life Questionnaire, Parkinson’s Disease Sleep Scale, Epworth Sleepiness Scale, and Parkinson’s Disease Fatigue Scale. Results Fatigue was found in 48% of patients. Patients with fatigue presented longer duration of illness, depressive symptoms, cognitive impairment, severity of motor symptoms, excessive daytime sleepiness and nocturnal sleep disorder. Fatigue combined with sleep disorder occurred in 21% of the total sample, being more frequent in females (32% vs 15%) and in patients at more advanced stages of the disease (52% in HY3). The multiple logistic regression analysis indicated that the significant independent variables for the presence of fatigue were: cognition (OR = 1.19 P = 0.02), nocturnal sleep disorder (OR = 1.03 P = 0.0001); among PDSS domains, nocturnal motor symptoms (OR = 1.09 P = 0.0005) and sleep refreshment (OR = 1.11 P = 0.02); among PDQ-39 domains, mobility (OR = 0.9323 P &lt; 0.0001) and body discomfort (OR = 0.9767 P = 0.0428). Conclusion Fatigue is common in PD, especially in the more advanced stages, and it seems to be associated with the female gender, nocturnal sleep disorder and cognition, having thus a negative impact on the quality of life.

scholarly journals Progression of Nonmotor Symptoms in Parkinson’s Disease by Sex and Motor Laterality

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Zimple Kurlawala ◽  
Paul H. Shadowen ◽  
Joseph D. McMillan ◽  
Levi J Beverly ◽  
Robert P. Friedland
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Symptom ◽  
Motor Symptoms ◽  
Healthy Controls ◽  
Nonmotor Symptoms ◽  
Start Up ◽  
Progression Markers

Nonmotor symptoms (NMS) in Parkinson’s disease (PD) can start up to a decade before motor manifestations and strongly correlate with the quality of life. Understanding patterns of NMS can provide clues to the incipient site of PD pathology. Our goal was to systematically characterize the progression of NMS in PD (n = 489), compared to healthy controls, HC (n = 241), based on the sex of the subjects and laterality of motor symptom onset. Additionally, NMS experienced at the onset of PD were also compared to subjects with scans without dopaminergic deficit, SWEDD (n = 81). The Parkinson’s Progression Markers Initiative (PPMI) database was utilized to analyze several NMS scales. NMS experienced by PD and SWEDD cohorts were significantly higher than HC and both sex and laterality influenced several NMS scales at the onset of motor symptoms. Sex Differences. PD males experienced significant worsening of sexual, urinary, sleep, and cognitive functions compared to PD females. PD females reported significantly increased thermoregulatory dysfunction and anxious mood over 7 years and significantly more constipation during the first 4 years after PD onset. Laterality Differences. At onset, PD subjects with right-sided motor predominance reported significantly higher autonomic dysfunction. Subjects with left-sided motor predominance experienced significantly more anxious mood at onset which continued as Parkinson’s progressed. In conclusion, males experienced increased NMS burden in Parkinson’s disease. Laterality of motor symptoms did not significantly influence NMS progression, except anxious mood. We analyzed NMS in a large cohort of PD patients, and these data are valuable to improve PD patients’ quality of life by therapeutically alleviating nonmotor symptoms.

scholarly journals The Epidemiology of Subjective Sleep Quality in the Citizens of Kermanshah, Iran

2020 ◽  
Vol 24 (2) ◽  
Author(s):  
Keivan Kakabaraee ◽  
Habibolah Khazaie ◽  
Azita Chehri ◽  
Maryam Seidy
Keyword(s):  
Quality Of Life ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Self Report ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Cross Sectional ◽  
Subjective Sleep ◽  
High Doses

Background: Subjective sleep quality plays a pivotal role in health, quality of life, and efficient performance. Objectives: The present study aimed to investigate the epidemiology of subjective sleep quality in the citizens of Kermanshah, Iran. Methods: This cross-sectional, descriptive study was conducted on all the citizens of Kermanshah in 2017. In total, 450 subjects were selected via multistage random sampling. Based on the inclusion criteria, 416 were evaluated using a self-report questionnaire of demographic characteristics and Petersburg sleep quality index (PSQI; Baisi et al., 1989). Results: In 79% of the participants, the mean score of PSQI was above the cutoff point (m = 6.64). The analysis of the questionnaires indicated the highest frequency of sleep disorders to be in the components of subjective sleep quality from the perspective of the respondents, delayed sleep, sleep disorders, and daily functional disorders. In addition, 10.6% of the subjects used very high doses of sedatives, while 10.3% used relatively high doses of these pills. Minimal sleep disorders were reported as well. Poor sleep quality was less common in women, and significant correlations were observed between age and sleep latency, sleep duration, sleep medication use, and daytime dysfunction due to sleepiness. Conclusions: According to the results, subjective sleep quality was favorable in the citizens of Kermanshah. Considering the significant effects of sleep quality on performance and quality of life, attention must be paid to this aspect of health by healthcare planners and managers.

scholarly journals Prevalence of non-motor symptoms in Parkinson’s disease

2019 ◽  
Vol 7 (5) ◽  
pp. 1459
Author(s):  
Shakthi C. ◽  
Sritharan B. ◽  
Muthuveeran M. ◽  
Manivannan M. R. ◽  
Justin C. ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disturbances ◽  
Motor Symptom ◽  
Motor Symptoms ◽  
Nocturnal Sleep ◽  
Males And Females ◽  
Non Motor Symptoms

Background: Parkinson’s disease is a common neurodegenerative movement disorder characterised by motor symptoms of rest tremor, bradykinesia, rigidity and postural instability and non-motor symptoms (NMS) which include neuropsychiatric symptoms, sleep disturbances, autonomic symptoms, sensory symptoms and symptoms of mixed aetiology. Parkinson’s Disease Non Motor Group (PD-NMG) devised a comprehensive clinic-based self-completed NMS questionnaire that allows easy identification of NMS by the physician. Most NMS have a poor response to dopaminergic therapy as it is due to dysfunction of the serotonergic and noradrenergic pathways. Treatment of these nonmotor symptoms help in improving the quality of life in patients with Parkinson’s disease.Methods: There were 100 patients with Parkinson’s disease who had presented to our neuromedicine movement clinic were included in the study. Patients were diagnosed as PD based on UK Parkinson’s disease brain bank criteria. The inclusion criteria were diagnosis as PD, age >18 yrs, inclusion of both males and females and consent for the study. Patients with atypical parkinsonism and secondary parkinsonism, stroke, intake of antipsychotics were excluded from the study. Non motor symptom questionnaire was given to the study group and frequency of occurrence of each non motor symptoms and their predominance in both males and females were studied. The frequency of each NMS was calculated by computing the number of yes response and calculating the percentage related to the number of patients in the sample. Analysis was done to calculate the frequency of all NMS among the enrolled patient.Results: Nocturnal sleep disturbances (43%) were most common followed by constipation (29%).The most common non motor symptoms in males were constipation (20%), urinary urgency (18%) and nocturia (11%).The most common non motor symptoms in females were nocturnal sleep disturbance (25%), feeling sad (19%), unexplained pains (17%) and being anxious (13%).Conclusions: Non motor symptom questionnaire helps in screening patients with Parkinson’s disease of non-motor symptoms and aims at providing holistic treatment improving the quality of life.

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