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

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.

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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.

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

PLoS ONE ◽

10.1371/journal.pone.0259935 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0259935

Author(s):

Rocio Del Pino ◽

Ane Murueta-Goyena ◽

Unai Ayala ◽

Marian Acera ◽

Mónica Fernández ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Sleep Disturbances ◽

Sleep Problems ◽

Motor Impairment ◽

Nocturnal Sleep ◽

Nocturnal Problems ◽

Over Time

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.

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Early Daytime Sleepiness and Nighttime Slow-wave Sleep Disorganization in Progressive Macaque Model of Parkinson’s Disease

10.21203/rs.3.rs-1216338/v1 ◽

2022 ◽

Author(s):

Aurélie Davin ◽

Stéphan Chabardès ◽

Hayat Belaid ◽

Daniel Fagret ◽

Loic Djaileb ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Early Stage ◽

Clinical Signs ◽

Human Condition ◽

Sleep Behavior ◽

Behavior Disturbances ◽

Nighttime Sleep

Abstract Parkinsonian patients often experience wake/sleep behavior disturbances, which can appear at an early stage of the disease in a way that is still not fully described. We aimed here at reproducing and characterizing these clinical signs in a progressive non-human primate model of the Parkinson’s disease to better understand the underlying physiopathology and to identify biomarkers of the disease. Three adult non-human primates (macaca fascicularis) were equipped with a polysomnographic telemetry system allowing the characterization of the wake/sleep behavior by long-term neurophysiological recordings and a modified multiple sleep latency test. Experiments were first performed in healthy animals and then during the progressive induction of a parkinsonian syndrome by chronic intramuscular injections of low doses of MPTP. We observed a significant early onset of wake/sleep behavior disturbances, before any motor symptoms, resulting in (i) a disorganization of nighttime sleep with more deep sleep and (ii) a disorganization of daytime naps with an excessive daytime sleepiness characterized by longer duration of naps, which occurred faster. These observations persisted and worsened in stable symptomatic state. In that latter state, we observed persistent excessive daytime sleepiness and more disorganized nighttime sleep architecture and continuity. Interpolating to the human condition, the present study suggests that nighttime and daytime sleep disorders may appear in early stage of the disease. They could thus be used as biomarkers of the disease for early stratification of patients who are at risk of developing Parkinson’s disease.

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