Articlehybrid2020

Progression of sleep disturbances in Parkinson’s disease: a 5-year longitudinal study

Zheyu Xu · Kirstie N. Anderson · Seyed Ehsan Saffari · Rachael Ashleigh Lawson · К. Ray Chaudhuri · David James Brooks +1 more

66 citations0/0 files storedJournal of Neurology

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Abstract

BACKGROUND: Sleep disorders can occur in early Parkinson's disease (PD). However, the relationship between different sleep disturbances and their longitudinal evolution has not been fully explored. OBJECTIVE: To describe the frequency, coexistence, and longitudinal change in excessive daytime sleepiness (EDS), insomnia, and probable REM sleep behavior disorder (pRBD) in early PD. METHODS: Data were obtained from the Parkinson's Progression Markers Initiative (PPMI). EDS, insomnia, and pRBD were defined using the Epworth Sleepiness Scale, MDS-UPDRS Part I sub-item 1.7, and RBD screening questionnaire. RESULTS: 218 PD subjects and 102 controls completed 5 years of follow-up. At baseline, 69 (31.7%) PD subjects reported one type of sleep disturbance, 25 (11.5%) reported two types of sleep disturbances, and three (1.4%) reported all three types of sleep disturbances. At 5 years, the number of PD subjects reporting one, two, and three types of sleep disturbances was 85 (39.0%), 51 (23.4%), and 16 (7.3%), respectively. Only 41(18.8%) patients were taking sleep medications. The largest increase in frequency was seen in insomnia (44.5%), followed by EDS (32.1%) and pRBD (31.2%). Insomnia was the most common sleep problem at any time over the 5-year follow-up. The frequency of sleep disturbances in HCs remained stable. CONCLUSIONS: There is a progressive increase in the frequency of sleep disturbances in PD, with the number of subjects reporting multiple sleep disturbances increasing over time. Relatively a few patients reported multiple sleep disturbances, suggesting that they can have different pathogenesis. A large number of patients were not treated for their sleep disturbances.

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References

1991A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale 2005Progressive sleep ‘destructuring’ in Parkinson's disease. A polysomnographic study in 46 patients 2016Changes in insomnia subtypes in early Parkinson disease 2017High Frequency of Sleep Disorders in Parkinson’s Disease and Its Relationship with Quality of Life 2015Gender differences in REM sleep behavior disorder: a clinical and polysomnographic study in China

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