Excessive Daytime Sleepiness in Parkinson's Disease

Shen, Yun; Huang, Junying; Li, Jie; Liu, Chun‐Feng

doi:10.4103/0366-6999.229889

Cited by 41 publications

(33 citation statements)

References 82 publications

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“…Sleep disturbances are one of the most common and disabling nonmotor manifestations of Parkinson's disease (PD), affecting almost 80% of patients (Shen et al., 2018). Disrupted sleep–wake cycles contribute to poor quality of life and increased risk for accidents, leading to increased morbidity and mortality in the PD population (Rocha et al., 2015).…”

Section: Introductionmentioning

confidence: 99%

“…EDS affects a large percentage of PD patients, and it is considered to be a possible preclinical marker of the disease itself (Abbott et al., 2005), although EDS is related to disease duration (Shen et al., 2018), and the occurrence of EDS in idiopathic REM behavior disorder does not predict the conversion to PD (Postuma et al., 2017). The therapies used to treat the motor symptoms contribute to the onset of EDS, but Tholfsen et al.…”

Section: Introductionmentioning

confidence: 99%

“…Given the strong impact of EDS, many randomized controlled trials tested different types of possible treatments in these patients: modafinil (Hogl et al., 2002; Ondo et al., 2005; Rodrigues et al., 2016), caffeine (Noyce et al., 2012; Postuma et al., 2012), methylphenidate (Devos et al., 2007), istradefylline (Du & Chen, 2017; Suzuki et al., 2017), and memantine (Ondo et al., 2011), but none of them proved their effectiveness (Seppi et al., 2011; Shen et al., 2018); sodium oxybate showed promising results, but it cannot be considered a first‐choice drug because it is a depressant of the nervous system and respiratory system and has a potential for addiction (Ondo et al., 2008).…”

Section: Introductionmentioning

confidence: 99%

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Selegiline reduces daytime sleepiness in patients with Parkinson's disease

Gallazzi¹,

Mauri

Bianchi³

et al. 2021

Brain and Behavior

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Objectives Excessive daytime sleepiness (EDS) affects a large percentage of Parkinson's disease (PD) patients, and it is enhanced by dopamine agonist drugs. Currently, there is no treatment of choice for EDS in PD. Our aim was to check the clinical impression that some patients who were given selegiline, a selective inhibitor of monoamine oxidase B, experienced an improvement in their daytime somnolence. Methods In the present study, we retrospectively identified 45 Parkinson's disease patients (21 females and 24 males) among those referred to the PD Center in Varese that (a) showed excessive daytime sleepiness, usually developed after the introduction of a dopamine agonist, (b) were given selegiline 10 mg to improve their treatment schedule independently of excessive sleepiness, and (c) in whom the Epworth Sleepiness Scale (ESS) and the Parkinson's Disease Sleep Scale (PDSS) scores were available both before and 3 months after the introduction of selegiline. Results We compared the corresponding scores (ESS, PDSS, and UPDRS III) evaluated before and 3 months after the introduction of selegiline by the nonparametric Mann–Whitney U test: The differences showed a statistically significant improvement of somnolence but no change in the UPDRS III scores. Conclusion Despite some limitations, our data suggest that selegiline may be a valuable add‐on therapy in PD patients to reduce their daytime somnolence.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Selegiline reduces daytime sleepiness in patients with Parkinson's disease

Gallazzi¹,

Mauri

Bianchi³

et al. 2021

Brain and Behavior

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“…The acquired results were in accordance with the findings in literature. While it was observed in a study during which ESS and multiple sleep latency test (MSLT) were used for evaluating daytime sleepiness in patients with Parkinson disease that daytime sleepiness is observed in 46.3% of the patients according to ESS which is a subjective test; it was observed that the ratio decreased to 13.4% when MSLT is used which is an objective test (34). We also determined a high ratio of 53.85% in our study for daytime sleepiness according to ESS.…”

Section: Discussionmentioning

confidence: 99%

The evaluation of sleep quality, anxiety disorder and depression in older adults with Parkinson disease

Ilkhan¹,

Çelikhisar

Kılavuz

2021

Journal of Health Sciences and Medicine

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The aim of this study was to examine the prevalence ratios of sleep disorder, anxiety and depression in older adults with Parkinson disease in addition to the relationship between these complaints and the stage and duration of the disease. Material and Method: Epworth sleepiness scale, Pittsburgh sleep quality index, Insomnia severity index, Beck depression inventory, Hamilton anxiety scale were applied on a total of 585 older adults followed up with Parkinson disease diagnosis. The acquired results were interpreted by comparing with the data of the control group comprised of 585 healthy individuals. Results: A total of 585 older adult with Parkinson disease and 585 healthy controls were included in the study. Each group was comprised of 255 female (43.59%) and 330 male (56.41%) participants. Mean age of the Parkinson group was 68.14±7.01 years, whereas mean age of the control group was 65.08±6.43 years. Mean Hoehn Yahr scale was determined in the Parkinson group as 1.8; while mean UPDRS was 29.8. Daytime functions and subjective sleep quality were worse at a statistically significant level in the patient group according to Pittsburgh sleep quality index (p=0.014, p=0.019, respectively). The most significant difference was observed in ESS when the scale scores of the patient and control groups were compared (p<0.001). A positive and statistically significant correlation was determined between the Beck depression inventory score and unified Parkinson's disease rating scale and Hoehn Yahr scale (p=0.023, p=0.034, respectively). While depression ratio increases with increasing stages of the disease, anxiety ratios increased with increasing disease duration. A positive and statistically significant correlation was determined between the weight of the disease and the score obtained from the somatic section of HAM-A (p=0.022). Conclusion:The presence of depression and anxiety should be questioned especially in older adult with Parkinson disease who are clinically more severe and who have been undergoing treatment for a longer period of time; patients with treatment related complications should be evaluated with regard to sleep disorders. It should be kept in mind that the Parkinson disease is not related only with motor symptoms but that an effective treatment of the non-motor symptoms will also improve the quality of life of the patients.

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“…It was suggested as a treatment possibility for apathy and fatigue in PD patients (Table 1). 4,[64][65][66][67] Dual Inhibition of Dopamine and Serotonin Uptake UWA-101 [2-(1,3-benzodioxol-5-yl)-1-cyclopropyl-N-methy lethanamine], UWA-121 and S-3,4-methylenedioxy methamphetamine (MDMA) not only constrain DRT, but also the 5-hydroxytryptamine (serotonin, 5-HT) reuptake (SRT). [68][69][70] To date, they were examined only in experimental PD models.…”

Section: Clinical Trialsmentioning

confidence: 99%

Experimental Dopamine Reuptake Inhibitors in Parkinson’s Disease: A Review of the Evidence

Müller¹

2021

JEP

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Parkinson's disease (PD) is the second most chronic neurodegenerative disorder worldwide. Deficit of monoamines, particularly dopamine, causes an individually varying compilation of motor and non-motor features. Constraint of presynaptic uptake extends monoamine stay in the synaptic cleft. This review discusses possible benefits of dopamine reuptake inhibition for the treatment of PD. Translation of this pharmacologic principle into positive clinical study results failed to date. Past clinical trial designs did not consider a mandatory, concomitant stable inhibition of glial monoamine turnover, i.e. with monoamine oxidase B inhibitors. These studies focused on improvement of motor behavior and levodopa associated motor complications, which are fluctuations of motor and non-motor behavior. Future clinical investigations in early, levodopa-and dopamine agonist naïve patients shall also aim on alleviation of non-motor symptoms, like fatigue, apathy or cognitive slowing. Oral levodopa/dopa decarboxylase inhibitor application is inevitably necessary with advance of PD. Monoamine reuptake (MRT) inhibition improves the efficacy of levodopa, the blood brain barrier crossing metabolic precursor of dopamine. The pulsatile brain delivery pattern of orally administered levodopa containing formulations results in synaptic dopamine variability. Ups and downs of dopamine counteract the physiologic principle of continuous neurotransmission, particularly in nigrostriatal, respectively mesocorticolimbic pathways, both of which regulate motor respectively non-motor behavior. Thus synaptic dopamine pulsatility overwhelms the existing buffering capacity. Onset of motor and non-motor complications occurs. Future MRT inhibitor studies shall focus on a stabilizing and preventive effect on levodopa related fluctuations of motor and non-motor behavior. Their long-term study designs in advanced levodopa treated patients shall allow a cautious adaptation of oral l-dopa therapy combined with a mandatory inhibition of glial monoamine turnover. Then the evidence for a preventive and beneficial, symptomatic effect of MRT inhibition on motor and non-motor complications will become more likely.

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Excessive Daytime Sleepiness in Parkinson's Disease

Cited by 41 publications

References 82 publications

Selegiline reduces daytime sleepiness in patients with Parkinson's disease

Selegiline reduces daytime sleepiness in patients with Parkinson's disease

The evaluation of sleep quality, anxiety disorder and depression in older adults with Parkinson disease

Experimental Dopamine Reuptake Inhibitors in Parkinson’s Disease: A Review of the Evidence

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