Clinical long-term nocturnal sleeping disturbances and excessive daytime sleepiness in Parkinson’s disease

Objective To prospectively evaluate nocturnal sleep problems and excessive daytime sleepiness (EDS) in Parkinson’s disease (PD) patients, and analyze the influence of motor symptoms, treatment, and sex differences on sleep problems in PD. Methods Sleep disturbances of 103 PD patients were assessed with Parkinson’s Disease Sleep Scale (PDSS) and the Epworth Sleepiness Scale (ESS). Student’s t-test for related samples, one-way ANOVA with Tukey’s HSD post hoc test were used to assess group differences. Bivariate correlations and mixed-effects linear regression models were used to analyze the association between clinical aspects and sleep disturbances over time. Results At baseline, 48.5% of PD patients presented nocturnal problems and 40% of patients presented EDS. The PDSS and ESS total score slightly improve over time. Nocturnal problems were associated with age and motor impartment, explaining the 51% of the variance of the PDSS model. Males presented less nocturnal disturbances and more EDS than females. Higher motor impairment and combined treatment (L-dopa and agonist) were related to more EDS, while disease duration and L-dopa in monotherapy were related to lower scores, explaining the 59% of the model. Conclusions Sleep disturbances changed over time and age, diseases duration, motor impairment, treatment and sex were associated with nocturnal sleep problems and EDS. Agonist treatment alone or in combination with L-dopa might predict worse daytime sleepiness, while L-dopa in monotherapy is related to lower EDS, which significantly affects the quality of life of PD patients.

Download Full-text

The Effect of Rotigotine on Cognitive Function and Sleep Problems in Parkinson's Disease: an Open-Label Pilot Study

10.21203/rs.3.rs-138691/v1 ◽

2021 ◽

Author(s):

Keisuke Suzuki ◽

Kei Funakoshi ◽

Hiroaki Fujita ◽

Koichi Hirata

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Function ◽

Daytime Sleepiness ◽

Sleep Disturbances ◽

Rating Scale ◽

Sleep Problems ◽

Motor Symptoms ◽

Open Label ◽

Updrs Part

Abstract Background: We hypothesized that rotigotine may have a positive effect on cognitive function in patients with Parkinson’s disease (PD) by improving daytime motor function and nighttime sleep status due to its 24-hour sustained properties.Methods: We evaluated the effect of rotigotine on motor symptoms, cognitive function, daytime sleepiness, sleep disturbances, and motor symptoms in 10 PD patients with sleep disturbances, defined as a PD Sleep Scale (PDSS)-2 score of ≥ 15, in a single-center, 3-month open-label study. Participants received 24 mg/24 h (patch content: 4.5-9 mg) rotigotine for a 3-month period. At baseline and 3 months, patients were evaluated on the Movement Disorder Society Revision of the Unified PD Rating Scale (MDS-UPDRS) parts III and IV and cognitive assessments, such as the Mini-Mental State Examination (MMSE), frontal assessment battery (FAB) and Montreal Cognitive Assessment (MoCA). The Epworth Sleepiness Scale (ESS) and PDSS-2 were administered at baseline and at 1 month, 2 months and 3 months.Results: At 3 months, MDS-UPDRS part III (-10.7, p<0.001) and MDS-UPDRS part IV (-1.0, p=0.023) scores significantly decreased, MoCA scores (1.7, p=0.0095) significantly increased, and off time significantly decreased (-43.0 min; p=0.029) from baseline. PDSS-2 scores significantly decreased from baseline at 2 months (-14.5, p<0.05) and 3 months (-20.0, p<0.001). ESS, MMSE or FAB scores did not significantly change after rotigotine treatment.Conclusion: Our preliminary findings suggest that low-dose rotigotine could improve motor symptoms, sleep disturbance, and cognitive function without worsening daytime sleepiness in patients with PD.

Download Full-text

Sleep disturbances in newly diagnosed patients with early stages of Parkinson’s disease

Practical medicine ◽

10.32000/2072-1757-2020-5-117-123 ◽

2020 ◽

Vol 18 (5) ◽

pp. 117-123

Author(s):

D. M. KHASANOVA ◽

◽

Z. A. ZALYALOVA ◽

S. E. MUNASIPOVA ◽

◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Sleep Disturbances ◽

Control Group ◽

Newly Diagnosed ◽

Falling Asleep ◽

Lack Of Sleep ◽

Nighttime Sleep

According to numerous worldwide studies, patients with Parkinson’s disease (PD) often experience sleep disturbances, the most common of which are insomnia and excessive daytime sleepiness. The purpose of this study was to determine the quantitative and qualitative profile of sleep disorders in patients with the newly diagnosed PD, stages 1 and 2 according to Hoehn and Yahr. The assessment was carried out using the SCOPA-SLEEP scale. The study involved 95 people: 56 patients with a newly diagnosed PD, who had not previously received treatment (main group), and 39 individuals from the control group. Results. The profile of nocturnal sleep disturbances in PD patients was characterized by various symptoms: difficulty falling asleep (62,5%), night awakening (51,8%), long lying awake (57,1%), early awakening (50,0%), feeling lack of sleep (46,4%). In women, irrespective of the form and stage of PD, disturbances in nighttime sleep were found more often. Daytime hypersomnia among healthy volunteers was observed only in 5 participants (12,8%). The profile of daytime hypersomnia in PD patients was diverse: unexpected falling asleep during the day (n = 15, 26,8%), falling asleep in a calm environment (n = 17, 30,4%) or while reading and watching TV (n = 18, 32,1%). Difficulties in maintaining wakefulness during the day were noted by 13 patients (n = 13, 23,2%) with PD, and 4 patients (7,2%) reported difficulties due to excessive daytime sleepiness. Thus, given the prevalence and profile of dyssomnias, sleep disturbances may be an important sign of PD.

Download Full-text

Association between sleep disorders and cognitive dysfunctions in non-demented patients with advanced Parkinson’s disease

Journal of Neurology ◽

10.1007/s00415-021-10726-z ◽

2021 ◽

Author(s):

Elisa Montanaro ◽

Alberto Romagnolo ◽

Margherita Fabbri ◽

Carlo Alberto Artusi ◽

Gabriele Imbalzano ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Executive Functions ◽

Daytime Sleepiness ◽

Sleep Disturbances ◽

Short Term Memory ◽

Sleep Problems ◽

Neuropsychological Test ◽

Neuropsychological Functions ◽

The Relationship

Abstract Background Parkinson’s disease (PD) is increasingly recognized as a multidimensional disorder, characterized by several non-motor symptoms, including disturbances of sleep and cognition. Current studies on the relationship between sleep problems and neuropsychological functions, mainly conducted in early to moderate PD patients, outline mixed results. In this study, we analysed the relationship between subjectively reported sleep alterations and cognitive functions in a large cohort of 181 advanced PD patients. Methods All consecutive, non-demented, advanced PD patients candidates for device-aided therapy completed two self-administered sleep questionnaires—the Parkinson’s Disease Sleep Scale (PDSS-2) and the Epworth Sleepiness Scale (ESS)—and underwent a comprehensive battery of neuropsychological tests encompassing five cognitive domains (reasoning, memory, attention, frontal executive functions, and language). Results Patients showed mild to moderate sleep problems (PDSS-2 score: 23.4 ± 1.2) and mild daytime sleepiness (ESS 8.6 ± 5.1). A significant correlation was found between PDSS-2 total score and non-verbal reasoning, as well as attentive skills, executive functions, and language abilities. No correlations were found between sleep measures and memory tests scores. Patients with clinically relevant sleep disturbances performed worse on attention, executive functions, and language. No significant correlations were found between daytime sleepiness and any neuropsychological test. Conclusions In advanced PD patients, sleep disturbances selectively correlate with specific neuropsychological functions and not with short-term memory and consolidation. Even if confirmations by means of longitudinal studies are needed, our observations suggest the importance of considering treatment of sleep disturbances to minimize their potential impact on cognition.

Download Full-text