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

Abstract

Obstructive sleep apnea (OSA) occurs in up to 66% of Parkinson's disease (PD) patients, higher than in the general population. Although it is more prevalent, the relationship between OSA and PD remains controversial, with some studies confirming and others denying the relationship of OSA with some risk factors and symptoms in patients with PD. Objective: To determine the factors associated with OSA in PD patients com DP. Methods: A cross-sectional study was performed with 88 consecutive patients with PD from the outpatient clinic. Participants underwent clinical interviews with neurologists and a psychiatrist, assessment using standardized scales (Epworth Sleepiness Scale, Parkinson's Disease Questionnaire, Pittsburgh Sleep Quality Index and, for individuals with a diagnosis of restless legs syndrome/Willis-Ekbom disease, the International Restless Legs Syndrome Rating Scale), and video-polysomnography. Results: Individuals with PD and OSA were older and had less insomnia than those with PD without OSA. Regarding the polysomnographic variables, we observed a lower percentage of stage N3 sleep, a higher arousal index, and a higher oxygen desaturation index in those individuals with OSA, relative to those without OSA. In the multivariate analysis, only the percentage of stage N3 sleep and the oxygen desaturation index were significantly different. Besides this, most of the PD patients with OSA had a correlation with sleeping in the supine position (58% of OSA individuals). Conclusion: The PD patients showed a high prevalence of OSA, with the supine position exerting a significant influence on the OSA in these patients, and some factors that are associated with OSA in the general population did not seem to have a greater impact on PD patients.

Impact of Obstructive Sleep Apnea on Cognitive and Motor Functions in Parkinson's Disease

“…36,37 Furthermore, a few studies compared PD patients who had OSA (PD + OSA) with PD patients who did not have OSA (PD -OSA), and the comparison included motor and/or cognitive functions. 11,33,[38][39][40][41][42][43][44][45][46] Due to the discrepancy between the results of such studies, we conducted this systematic review and meta-analysis to assess how OSA influences both motor and cognitive functions in PD patients.…”

“…Seven studies 11,33,[38][39][40]42,43 assessed UPDRS III in PD + OSA patients in comparison with PD -OSA ones. The random-effect estimate of these seven studies (n = 738 patients) demonstrated that the UPDRS III score was significantly higher in the PD + OSA group (MD = 1.63, 95% CI [0.03, 3.23], P = 0.049).…”

“…H&Y scale was assessed in eight studies. 33,[38][39][40][41][43][44][45] The overall fixed-effect estimate of these eight studies (n = 813 patients) showed that there was no significant difference between PD + OSA patients and PD -OSA patients in terms of the H&Y scale (MD = 0.06, 95% CI [−0.04, 0.15], P = 0.26). Pooled studies were not homogenous (P = 0.05, I 2 = 50%).…”

“…Additionally, data from nine studies 11,33,[38][39][40][41][42][43][44] (n = 875 patients) showed that PD + OSA patients were on a lower level of L-dopa equivalent dose (MD = −58.63 mg/dL, 95% CI [−103.93, −13.34], P = 0.01). Pooled studies were not homogenous (P = 0.01, I 2 = 58%).…”

“…The pooled analysis of three studies [38][39][40] (n = 501) demonstrated that compared with the PD -OSA group, the PD + OSA group had a significantly lower mean MMSE score (MD = −0.69, 95% CI [−1.17, −0.21], P = 0.005). Pooled data were homogenous (I 2 = 14%, P = 0.31).…”