Poor nighttime sleep is positively associated with dyskinesia in Parkinson's disease patients

Abstract

Background Dyskinesia is a troublesome complication of long-term dopaminergic medications in Par-kinson’s disease (PD) patients. Many factors are reported to be associated with dyskinesia in PD. Objective To investigate the association between sleep quality and dyskinesia in patients with PD. Methods Four hundred twenty-five patients with PD were enrolled in this study. Demographic information was collected. Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr (H-Y) stage scale were also performed. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were applied to evaluate daytime sleepiness and overall nighttime sleep quality, respectively, in PD patients. Results Patients with dyskinesia tended to have a longer duration of disease, higher daily levodopa-equivalent dose (LED), H-Y stage, UPDRS II and PSQI score, and a higher percentage of levodopa treatment than those without dyskinesia. After adjusting for age, sex, age at onset of PD, disease duration, UPDRS I, UPDRS II, UPDRS III, cigarette smoking, use of different antiparkinsonian drugs, phenotype, daily LED, and restless leg syndrome (RLS), PSQI score was still associated with dyskinesia, with corresponding ORs 1.111 (95% CI, 1.004–1.229) as a continuous variable, and 2.469 (95% CI, 1.051–5.800) as a categorical variable, respectively. Further analysis of PSQI components showed that subjective sleep quality and sleep latency were associated with dyskinesia in PD patients. Conclusions Our data showed that poor nighttime sleep is positively associated with dyskinesia in PD patients. Attention to the management of nighttime sleep quality may be beneficial to dyskinesia in patients with PD.

Levodopa‐induced dyskinesia in Parkinson disease: Sleep matters

“…Our 1‐week actigraphy data demonstrated a clear negative correlation between eTST and the severity of dyskinesia. Poor nighttime sleep has been positively associated with LID in a recent study with a large cohort of patients . Along these lines, sleep deprivation has been shown to enhance LID in a rodent model and in PD patients .…”

“…DYS patients start from a lower early SWA level compared to the ADV and DNV subjects. However, the observed SWA reduction in early sleep could be a consequence of a chronic deficit of synaptic downscaling during the night in dyskinetic patients . In these respects, chronic sleep deprivation has been associated with an impairment of synaptic potentiation …”

Investigation on sleep and mental health of patients with Parkinson's disease during the Coronavirus disease 2019 pandemic

“…In addition, sleep disturbances may contribute to the progression of symptoms. Studies have shown that worsening of sleep quality and shortening of sleep duration are markers of the prodromal phase of PD and an increased number of sleep-related symptoms and poor night-time sleep are positively correlated with disease-related disability [ 6 , 26 ]. A recent study showed that sleep fragmentation recorded by actigraphy was associated with an increased burden of PD pathology in the brain [ 27 ].…”

Sleep Disorders in Rodent Models of Parkinson’s Disease

“…They are generally refractory to, or exacerbated, by standard anti-parkinsonian medications. In this context, it should be mentioned that impaired synaptic downscaling associated with sleep disruption may promote the emergence of motor complications caused by standard pharmacological therapy (Galati et al, 2015), and that this idea is supported by clinical studies indicating a correlation between disrupted sleep and l-3,4-dihydroxyphenylalanine (L-DOPA)-induced dyskinesia (Mao et al, 2018).…”