Obstructive sleep apnea, CPAP therapy and Parkinson's disease motor function: A longitudinal study

Meng, Lynn; Benedetti, Andrea; Lafontaine, Anne‐Louise; Mery, Victoria; Robinson, Ann; Kimoff, John; Gros, Priti; Kamińska, Marta

doi:10.1016/j.parkreldis.2019.12.001

Cited by 31 publications

(34 citation statements)

References 30 publications

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“…Med. 2020, 9, x FOR PEER REVIEW 4 of 23 significantly higher baseline motor MDS-UPDRS [50]. This was consistent with other studies in which motor function was worse in PD patients with OSA [41].…”

Section: Pathogenesis Of Cognitive Impairment In Osasupporting

confidence: 88%

“…The Timed Up-and-Go (TUG) is a test used to assess basic mobility, balance, and risk of falls in the elderly [49]. A prospective cohort study conducted by our group showed that PD patients with OSA had significantly higher baseline motor MDS-UPDRS [50]. This was consistent with other studies in which motor function was worse in PD patients with OSA [41].…”

Section: Osa and Motor Impairment In Pdsupporting

confidence: 86%

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Obstructive Sleep Apnea in Neurodegenerative Disorders: Current Evidence in Support of Benefit from Sleep Apnea Treatment

Lajoie

Lafontaine

Kimoff

et al. 2020

JCM

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Obstructive sleep apnea (OSA) is a prevalent disorder characterized by recurrent upper airway obstruction during sleep resulting in intermittent hypoxemia and sleep fragmentation. Research has recently increasingly focused on the impact of OSA on the brain’s structure and function, in particular as this relates to neurodegenerative diseases. This article reviews the links between OSA and neurodegenerative disease, focusing on Parkinson’s disease, including proposed pathogenic mechanisms and current knowledge on the effects of treatment.

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Section: Pathogenesis Of Cognitive Impairment In Osasupporting

confidence: 88%

Section: Osa and Motor Impairment In Pdsupporting

confidence: 86%

Obstructive Sleep Apnea in Neurodegenerative Disorders: Current Evidence in Support of Benefit from Sleep Apnea Treatment

Lajoie

Lafontaine

Kimoff

et al. 2020

JCM

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“…Sleep issues as well as comorbidities such as depression should be addressed regularly in routine care, which underlines the need for adequate diagnostic and therapeutic tools to address these issues. Complementary, screening for sleep apnea in PD patients, particularly in those with EDS or symptoms of insomnia, should be applied generously to detect SDB as this is mandatory to treat sleep disturbances and might be effective in preventing further cognitive decline and even motor progression ( Kaminska et al, 2018 ; Meng et al, 2019 ). As SDB is a treatable cause for sleep disturbances, patients should be evaluated regarding sleep disturbances more consequently, and treatment options such as positive airway pressure therapy should be applied in these patients.…”

Section: Discussionmentioning

confidence: 99%

Sleep Disturbances and Sleep Disordered Breathing Impair Cognitive Performance in Parkinson’s Disease

et al. 2020

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Background Sleep disturbances and impairment of cognitive function are among the most frequent non-motor symptoms in Parkinson’s disease (PD) with negative implications on quality of life of patients and caregivers. Despite the fact that sleep disturbances are a major issue in PD patients, only limited data are available regarding interactions of sleep disturbances and cognitive performance. Objective This post hoc analysis of the RaSPar trial was therefore designed to further elucidate sleep disturbances and their impact on cognition in PD. Methods Twenty-six PD patients with sleep disturbances were evaluated thoroughly including assessments of patients’ subjective and objective sleep quality by interview, questionnaires, and polysomnography (PSG). Cognitive performance was assessed by Parkinson Neuropsychometric Dementia Assessment (PANDA) and Test of Attentional Performance (TAP), and associations of sleep and cognitive function were evaluated. Results We did not detect differences in cognitive performance between patients with and without rapid eye movement (REM) sleep behavior disorder (RBD). Instead, cognitive impairment, particularly affecting cognitive domains attention, executive function/working memory, and semantic memory, was associated with impaired PSG-measured sleep quality (e.g., sleep efficiency) and sleep disordered breathing (SDB) (Apnea-Hypopnea Index > 5/h). Global cognitive performance was decreased in patients with SDB (PANDA score 23.2 ± 3.5 vs. 26.9 ± 2.2, P = 0.020, unpaired two-sided t -test). Conclusion Sleep apnea and other sleep disturbances impair cognitive performance in PD and should be evaluated in routine care, and treatment options such as continuous airway pressure therapy should be considered.

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“…Similar studies in other neurological disorders, as well as in the older general population have also defined lower AHI thresholds to account for possible differences in the aetiology of the sleep disordered breathing and to minimise Type I error [ 33 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

Prospective Trial of CPAP in Community-Dwelling Adults with Down Syndrome and Obstructive Sleep Apnea Syndrome

et al. 2020

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Adults with Down syndrome (DS) are predisposed to obstructive sleep apnoea (OSA), but the effectiveness and acceptability of continuous positive airway pressure treatment (CPAP) in this group has rarely been formally assessed. This study was designed as a pilot randomised, parallel controlled trial for one month, continuing as an uncontrolled cohort study whereby the control group also received the intervention. Symptomatic, community-dwelling DS individuals exhibiting ≥10 apnoeas/hypopneas per hour in bed on a Type 3 home sleep study were invited to participate in this study, with follow-up at 1, 3, 6, and 12 months from baseline. Measurements of sleepiness, behaviour, cognitive function and general health were undertaken; the primary outcome was a change in the pictorial Epworth Sleepiness Scale (pESS) score. Twenty-eight participants (19 male) were enrolled: age 28 ± 9 year; body mass index 31.5 ± 7.9 kg/m2; 39.6 ± 32.2 apnoeas/hypopneas per hour in bed; pESS 11 ± 6/24. The pilot randomised controlled trial at one month demonstrated no change between the groups. At 12 months, participant (p = 0.001) pESS and Disruptive (p < 0.0001), Anxiety/Antisocial (p = 0.024), and Depressive (p = 0.008) behaviour scores were reduced compared to baseline. Improvement was noted in verbal (p = 0.001) and nonverbal intelligence scores (p = 0.011). General health scores also improved (p = 0.02). At the end of the trial, 19 participants continued on treatment. Use of CPAP in adults with DS and OSA led to a number of significant, sustained improvements in sleepiness and behavioural/emotional outcomes at 12 months.

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Obstructive sleep apnea, CPAP therapy and Parkinson's disease motor function: A longitudinal study

Cited by 31 publications

References 30 publications

Obstructive Sleep Apnea in Neurodegenerative Disorders: Current Evidence in Support of Benefit from Sleep Apnea Treatment

Obstructive Sleep Apnea in Neurodegenerative Disorders: Current Evidence in Support of Benefit from Sleep Apnea Treatment

Sleep Disturbances and Sleep Disordered Breathing Impair Cognitive Performance in Parkinson’s Disease

Prospective Trial of CPAP in Community-Dwelling Adults with Down Syndrome and Obstructive Sleep Apnea Syndrome

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