Excessive Daytime Sleepiness in Parkinson’s Disease: Characteristics and Determinants

Poryazova, Rositsa; Benninger, David; Waldvogel, Daniel; Bassetti, Claudio L.

doi:10.1159/000276402

Cited by 91 publications

(88 citation statements)

References 71 publications

(73 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The occurrence of EDS among patients with PD was lower in Asian than in Caucasian populations in the literature. Studies from Asia using the ESS have reported that the prevalence of EDS ranged from 15.1% to 32.3%; however, prevalence ranging from 40.6% to 57% was reported for Europe and North America (Brodsky et al., 2003; Chen et al., 2015; Goldman et al., 2013; Hobson et al., 2002; Louter et al., 2012; Poryazova et al., 2010; Ratti et al., 2015; Setthawatcharawanich et al., 2014; Tan et al., 2002; Yu et al., 2015; Zhu et al., 2016) (Table 3). Disease severity, disease duration, dopaminergic therapy, and hypnotic medication have been suggested to contribute to EDS; however, neither of them could fully explain this discrepancy.…”

Section: Discussionmentioning

confidence: 99%

“…Disease severity, disease duration, dopaminergic therapy, and hypnotic medication have been suggested to contribute to EDS; however, neither of them could fully explain this discrepancy. The disease severity of the patients were similar in these Western and Asian studies, with H&Y stages between 2 and 3 (Poryazova et al., 2010; Setthawatcharawanich et al., 2014; Tan et al., 2002; Yu et al., 2015; Zhu et al., 2016). In a study of 638 Canadian patients with PD with H&Y stage of 2.2 ± 0.68, Hobson et al.…”

Section: Discussionmentioning

confidence: 99%

“…In our patient cohort and that investigated in Switzerland by Poryazova et al., the mean age (65.7 ± 8.88 vs. 65 ± 10 years) and disease duration (8.2 ± 5.2 vs. 8.2 ± 6.6 years) were similar; however, 57% of the patients studied by Poryazova et al. (2010) had EDS. In a study of 126 patients with PD in Cambridgeshire (UK), 49% had EDS even though the mean disease duration was only 3.54 years (Breen, Williams‐Gray, Mason, Foltynie, & Barker, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…Intriguingly, although the reported percentages of poor sleepers in Asian patients are equal to or slightly higher than those among Western populations, the prevalence of EDS is lower in Asian than in Caucasian patients. In the Western countries, such as France, the Netherlands, Switzerland, Canada, and the United States, the percentage of poor sleepers ranged from 58.8% to 63% and EDS ranged from 40.6% to 57% (Brodsky, Godbold, Roth, & Olanow, 2003; Hobson et al., 2002; Louter, Munneke, Bloem, & Overeem, 2012; Poryazova, Benninger, Waldvogel, & Bassetti, 2010; Ratti et al., 2015; Zhu, van Hilten, & Marinus, 2016). In Asia, EDS was found to be considerably less prevalent among patients with PD.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sleep disturbances in Taiwanese patients with Parkinson's disease

Lin

Chen

et al. 2017

Brain and Behavior

View full text Add to dashboard Cite

IntroductionSleep disturbance is a common nonmotor symptom of Parkinson's disease (PD) and strongly affects patients’ quality of life. The relationship between excessive daytime sleepiness (EDS) and nighttime problems remains uncertain. Arguments persist regarding the risk factors for sleep disturbance among patients with PD. Furthermore, the prevalence of EDS appears to be lower in Asian countries. Herein, we conducted the study to describe the characteristics of sleep problems in a sample of Taiwanese PD patients and delineate the difference with reported sleep disturbances in Caucasian PD patients from the literature.MethodsPatients with PD were recruited from the outpatient clinic of a tertiary medical center and were evaluated using standardized assessment protocols, including the Parkinson's Disease Sleep Scale (PDSS), the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and 39‐Item Parkinson's Disease Questionnaire (PDQ‐39).ResultsA total of 225 patients with PD were recruited. The mean age of patients with PD was 65.7 years old and the mean disease duration was 8.18 years. Among the patients, 53.8% were defined as poor sleepers (PSQI > 5) and 26.3% had EDS. Seventy‐one percent of the poor sleepers used hypnotic medications. The poor sleepers were worse in the scores of Unified Parkinson's Disease Rating Scale (UPDRS), PDSS, and the PDQ‐39, and received higher levodopa daily dosage. A PDSS score of <126 indicate that a patient with PD was a poor sleeper. EDS was positively correlated with advanced Hoehn and Yahr stages and use of dopamine agonists but not with levodopa daily dosage and levodopa equivalent daily dosage.ConclusionsTaiwanese patients with PD had a lower prevalence of EDS compared with the literatures reported in Caucasian patients. We identify and suggest that PDSS total score, rather than subcategory items, should be used to predict poor sleep among patients with PD.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sleep disturbances in Taiwanese patients with Parkinson's disease

Lin

Chen

et al. 2017

Brain and Behavior

View full text Add to dashboard Cite

show abstract

“…We observed that high doses of medications were associated with daytime sleepiness in accordance with other previous studies. 32,33 Although daytime sleepiness followed by nocturnal sleep disturbance has a large impact on quality of life in PD, control of medication-related daytime sleepiness may not be simple because high doses of antiparkinsonian medication may be necessary to reduce severe motor symptoms.…”

Section: Discussionmentioning

confidence: 99%

Insomnia and Sleepiness in Parkinson Disease: Associations with Symptoms and Comorbidities

Chung

Bohnen

Albin

et al. 2013

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Study Objectives: Insomnia and daytime sleepiness are common complaints in Parkinson disease (PD), but the main causes remain unclear. We examined the potential impact of both motor and non-motor symptoms of PD on sleep problems. Methods: Patients with PD (n = 128) were assessed using the Insomnia Severity Index, Epworth Sleepiness Scale, Unifi ed Parkinson Disease Rating Scale, Beck Depression Inventory, Fatigue Severity Scale, Survey of Autonomic Symptoms, and the 39-item Parkinson Disease Questionnaire. A subset of subjects (n = 38, 30%) also completed nocturnal polysomnography and a multiple sleep latency test (MSLT) S C I E N T I F I C I N V E S T I G A T I O N SS leep-related disturbances, including insomnia and excessive daytime sleepiness, are some of the most common complaints of patients with Parkinson disease (PD). As many as 60% to 76% of PD patients experience insomnia.1,2 Nocturnal hypokinesia, nocturnal and early morning dystonia, and impaired bed mobility are thought to be common causes.2,3 In practice, attention often focuses on motor symptoms of PD, and these are probably considered fi rst as possible causes of sleep disturbance. Although non-motor symptoms, such as depressed mood, anxiety, pain, or frequent nocturia tend to receive less clinical consideration, such symptoms could have substantial impact on sleep. 4 In particular, depression is the most common psychiatric problem in PD, with an estimated prevalence of 17% to 50%, 5,6 depending on the rating scales or structured clinical diagnosis used to identify the problem. Several studies have examined the relationship between depressed mood and sleep disturbance in PD patients. 7 The relative contributions, however, of motor and non-motor features to sleep disturbance remains unclear, despite the important impact that sleep disturbance can have on quality of life in patients with PD. Furthermore, the potential value of objective sleep laboratory data, in understanding sleep-related complaints in PD, remains unclear. The main objective of this study was to examine associations of both motor and non-motor PD symptoms with reported sleep problems. We hypothesized that non-motor and motor symptoms of PD patients would each show independent association with subjective insomnia or daytime sleepiness. In a subset of patients, we also assessed the extent to which polysomnography and the multiple sleep latency test (MSLT) may help to understand sleep complaints in PD. BRIEF SUMMARYCurrent Knowledge/Study Rationale: Sleep disturbance and daytime somnolence are common complaints in patients with Parkinson disease (PD), but the main causes remain unclear. This study was done to explore associations between sleep-related complaints and potential contributors, including both motor and non-motor PD symptoms. Study Impact: Non-motor features of PD, such as mild depressive symptoms, fatigue, and autonomic symptoms, are associated with subjective insomnia, whereas fatigue and dopaminergic medication dose are associated with subjective daytime sleepiness. I...

show abstract

Factors correlated with excessive daytime sleepiness in patients with Parkinson's disease: A polysomnography study

et al. 2023

View full text Add to dashboard Cite

ObjectiveTo explore the factors correlated with excessive daytime sleepiness (EDS) in patients with Parkinson's disease (PD).MethodsA total of 239 PD patients were divided into two groups based on the presence of EDS (Epworth Sleepiness Scale score≥10) (PD‐EDS vs. PD‐non‐EDS). Participants underwent an extensive assessment to determine demographic features, disease severity, polysomnography characteristics, and nonmotor symptoms.ResultsOf the 239 patients, 56 patients (23.4%) were classified as having PD combined with EDS. Binary logistic regression analysis showed that fatigue (Fatigue Severity Scale [FSS] score ≥4) (odds ratio [OR] [95% CI] = 4.897 [2.376–10.095], p < .001) and the respiratory‐related microarousal index (OR [95% CI] = 2.063 [1.085–3.923], p = .027) were independent risk factors for EDS in PD patients. A priori‐determined stratified analysis showed that after adjustment for confounding factors, the association of the respiratory‐related microarousal index with EDS was significant (OR = 4.404, 95% CI 1.673–11.592, p trend = .036) in patients with respiratory arousal index scores in the highest quintile compared with those with scores in the lowest quintile.ConclusionOur data revealed a close association among the respiratory‐related microarousal index, FSS scores, and EDS. It can be speculated that fragmented sleep and pathological abnormalities of the central nervous system resulting in changes in arousal are major influencing factors of EDS in PD.

show abstract

Excessive Daytime Sleepiness in Parkinson’s Disease: Characteristics and Determinants

Cited by 91 publications

References 71 publications

Sleep disturbances in Taiwanese patients with Parkinson's disease

Sleep disturbances in Taiwanese patients with Parkinson's disease

Insomnia and Sleepiness in Parkinson Disease: Associations with Symptoms and Comorbidities

Factors correlated with excessive daytime sleepiness in patients with Parkinson's disease: A polysomnography study

Contact Info

Product

Resources

About