Global cognitive performance is associated with sleep efficiency measured by polysomnography in patients with Parkinson's disease

Abstract

Aim Sleep disorders can be associated with an increased risk for cognitive decline in patients with Parkinson's disease (PD). The aim of this study was to examine the association between cognitive status and presence of sleep symptoms and sleep disorders in PD patients. Methods We evaluated excessive sleepiness, other sleep symptoms, and performed polysomnography and neuropsychological evaluation in 79 patients. They were classified as having normal cognition (PDNC), mild cognitive impairment (PDMCI), or dementia (PDD). Results There were 29 PDNC, 39 PDMCI, and 11 PDD patients. PDD patients were older, had higher scores on the Unified Parkinson's Disease Rating Scale, and lower Schwab and England Activities of Daily Living scores than PDNC patients. After analysis of the polysomnographic variables, it was also found that PDD patients had a lower sleep efficiency, lower total sleep time, and lower number of sleep state changes than PDNC patients. In a stepwise analysis, defining Mattis Dementia Rating Scale scores as the dependent variable, the results were a model that selected three variables that accounted for 59% of the variation in the Mattis Dementia Rating Scale score: wake time after sleep onset, number of state changes, and schooling. Conclusion We found a significant association between global cognitive performance and wake time after sleep onset and the number of state changes during sleep measured in the polysomnography of PD patients. However, we did not find any other association between sleep disorders or symptoms and cognitive status or cognitive performance of PD patients.

Prevalence and Clinical Aspects of Mild Cognitive Impairment in Parkinson's Disease: A Meta‐Analysis

“…A total of 9 of 25 studies found that patients with PD‐MCI took higher LEDD than patients without PD‐MCI; our meta‐analysis confirmed this association (Supplementary Material 5; Table ), with a significant and positive ES (= 0.25). The heterogeneity among the studies was significant and moderate, but sensitivity analysis indicated stability of ES level, and there was no publication bias.…”

“…Of 21 studies, 8 revealed that PD‐MCI patients had higher H&Y stages than patients without PD‐MCI (Supplementary Material 5). Our meta‐analytic study showed that PD‐MCI patients had higher scores on the H&Y (Table ), with a significant and positive ES (= 0.33).…”

“…Sex. A total of 3 27,52,54 of 35 studies 4,5,11,12,14,15,[26][27][28][29][30][31][32][34][35][36][37][38][39][40][41][42][43][44][45][46][47][49][50][51][52][53][54]56,57 found an association between PD-MCI and male sex ( Supplementary Material 4). Our meta-analysis revealed a significant association between male sex and the occurrence of PD-MCI ( 4,10,12,14,33,38,39,[41][42][43]45,47,57 found an association between PD-MCI and a lower level of education ( Supplementary Material 4).…”

Obstructive sleep apnea and Parkinson's disease: characteristics and associated factors

“…Contrary to what was expected, some studies demonstrated that the presence of OSA in patients with PD was not associated with excessive sleepiness, cognitive deficit, depressive symptoms, nocturia, or cerebrovascular diseases [6][7][8][9] . Specific aspects of PD, such as the levodopa equivalent dose and disease severity, were also not related to OSA 10 .…”

“…Although it is more prevalent, the relationship between OSA and PD remains controversial, with some studies confirming and others refuting the relationship of OSA with some risk factors and symptoms in patients with PD 6,7,8,9,10,11,12,13 .…”