Effect of sleep deprivation on motor performance in patients with Parkinson's disease

Abstract

Animal research provides evidence that sleep deprivation influences the dopamine system. Knowledge about the effect of sleep deprivation on motor performance in patients with Parkinsons disease is scarce. This study examines the influence of total and partial sleep deprivation compared to normal sleep on motor state and performance in Parkinson's disease. Fifteen nondepressed patients with Parkinson's disease underwent one night of total sleep deprivation (TSD), one night of partial sleep deprivation (PSD) after 3 a.m., and one control night of normal sleep (S), performed in a random, nonconsecutive order. Over a period of 3 hours the following morning, motor evaluations (United Parkinson's Disease Rating Scale, [UPDRS] and tapping rate) were performed before and every 30 minutes after intake of the usual morning dopaminergic drug dose. All patients underwent polysomnography apart from the sleep deprivation protocol. Mean UPDRS motor scores and tapping velocities did not differ significantly after each of the schedules, but a subgroup of four patients improved their motor score after partial sleep deprivation. These data do not confirm previous findings of an overall positive influence of sleep deprivation on motor function in Parkinson's disease. However, the results indicate that different response types to sleep deprivation may exist and that a subgroup of patients could benefit from partial sleep deprivation.

Sleep-Wake Disturbances in Parkinson’s Disease: Current Evidence regarding Diagnostic and Therapeutic Decisions

“…This apparent paradox remains unexplained, as does the question of why only a subgroup of patients benefit from sleep. These unsolved issues have been further challenged by a recent report confirming that sleep deprivation improves motor function in a subgroup of PD patients [24]. One possible explanation is that the influence of sleep or sleep deprivation on PD depends on some particular aspects of the disease in the patient.…”

Levodopa availability improves with progression of Parkinson’s disease

“…Levodopa plasma levels were measured at fixed time points (0, 15, 30, 45, 60, 90, 120, 150,180 minutes) between 6.30 a.m. to 9.30 a.m. All participants were on identical standardized conditions until 9.30 a.m., they received an identical breakfast (Fresubin OriginalÒ (content in 100 ml: protein 3.8 gram [g], carbohydrate 13.8 g, fat 3.8 g, water 84 ml) at 6.00 a.m. and mostly remained in the sitting position. We scored all PD patients at baseline in the off state before levodopa intake with the UPDRS and Hoehn and Yahr Scale in the morning [8,10,11].…”

Sleep Deprivation in Mood Disorders

“…A higher lifetime sleep duration has been associated with a higher risk of developing this disease, while rotating shift work and sleep loss had a protective effect [106] . Probably due to the marked increase in dopaminergic neurotransmission associated with SD, sleep-deprived patients affected by Parkinson's disease temporarily improved their motor scores after total [22,107,108] or partial SD [109] , and the improvement in motor symptoms was associated with a more prolonged amelioration of depression [110] . In subgroups of patients, however, a sleep benefit and a worsening after SD have been reported [111] , and caution should thus be used in administering antidepressant SD to patients with Parkinson's disease.…”