REM sleep behavior disorder in sleep-disordered patients with versus without Parkinson's disease: is there a need for polysomnography?

Eisensehr, Ilonka; Lindeiner, H v; Jäger, Markus; Noachtar, Soheyl

doi:10.1016/s0022-510x(01)00480-4

Cited by 119 publications

(90 citation statements)

References 18 publications

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“…In two of the five case-control studies, RBD-D was not elevated in PD patients, 27,28 although an additional two studies revealed that RBD-D and RWA were higher in those with PD. 29,30 WASO and sleep 1 stage were significantly longer in the PD compared with the control group in the initial analysis of our study, but these data were not statistically significant after age adjustment. This suggests that the difference observed initially may have been related to age.…”

Section: Discussioncontrasting

confidence: 66%

Sleep Disturbances in Essential Tremor and Parkinson Disease: A Polysomnographic Study

Barut

Taşçılar

Varo

2015

Journal of Clinical Sleep Medicine

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are prone to error. Importantly, the study performed by Gerbin recommended a combination of sleep diaries and polysomnography be used in future studies to investigate sleep problems in patients with ET. 6 The aim of our study was to evaluate sleep disturbances and sleep-related events in patients with ET, PD, and controls, using both self-assessment tools and polysomnographic readings. METHODS Study SampleThe ethics committee of Bülent Ecevit University approved this prospective study, and informed consent was obtained from all participants. Between 2010 and 2012, 21 patients with PD who fulfi lled the Parkinson Disease Society Bank criteria, 9 and 16 patients with ET who fulfi lled Movement Disorders BRIEF SUMMARY Current Knowledge/Study Rationale: Sleep problems in ET and PD patients had been investigated in few studies by using subjective assessment tools like self-report questionnaires previously. This study was conducted to evaluate and to compare sleep problems in these two common movement disorders by using PSG which is an objective assessment tool. Study Impact: This study will improve the knowledge about sleep problems in ET and PD patients. Furthermore this is the fi rst study comparing sleep problems in ET and PD patients using PSG.Objective: Sleep problems are a common non-motor complication of Parkinson disease (PD), and patients with essential tremor (ET) share a number of motor and non-motor features of PD. To clarify the relationship between these disorders, we evaluated the sleep problems in patients with ET and PD using assessment scales and objective polysomnographic (PSG) testing. Method: Twenty-one consecutive patients with PD, 16 with ET, and 14 healthy subjects participated in this study and were compared in terms of sleep related complaints, fi nal sleep related diagnosis, and polysomnographic features. Results:The results of our study have shown that patients with PD were more likely than were those with ET to have a history of REM sleep behavior disorders (RBD) (p = 0.001) and excessive daytime sleepiness (p ≤ 0.05). Additionally, PSG data revealed that ET patients had lower mean SpO 2 values (p ≤ 0.05) and REM without atonia (RWA) (p = 0.032) than did patients with PD. Conclusion: This is the fi rst study to use PSG to evaluate sleep problems both in ET and PD patients. The results point out different sleep problems in these two common movement disorders which should be investigated in further studies. Keywords: essential tremor, Parkinson disease, sleep, REM behavior disorder (RBD), REM without atonia (RWA) Citation: Barut BO, Tascilar N, Varo A. Sleep disturbances in essential tremor and Parkinson disease: a polysomnographic study.

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Section: Discussioncontrasting

confidence: 66%

Sleep Disturbances in Essential Tremor and Parkinson Disease: A Polysomnographic Study

Barut

Taşçılar

Varo

2015

Journal of Clinical Sleep Medicine

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“…As a matter of fact, this questionnaire has never been validated in PD patients. The frequency of RBD in PD, as diagnosed by questionnaires, is different from video-polysomnographically diagnosed RBD (its frequency ranges from 33-47%), demonstrating the difficulty to predict RBD clinically [14,28,29]. It should be noted, however, that in a recent Japanese study, 54% of PD patients studied were diagnosed with RBD, based on questionnaire data [30].…”

Section: Sleepwalking and Parkinson's Disease: Prevalencementioning

confidence: 88%

Sleepwalking in Parkinson’s disease: a questionnaire-based survey

Oberholzer

Poryazova

2011

J Neurol

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Sleepwalking (SW) corresponds to a complex sleep-associated behavior that includes locomotion, mental confusion, and amnesia. SW is present in about 10% of children and 2-3% of adults. In a retrospective series of 165 patients with Parkinson's disease (PD), we found adult-onset (''de novo'') SW ''de novo'' in six (4%) of them. The aim of this study was to assess prospectively and systematically the frequency and characteristics of SW in PD patients. A questionnaire including items on sleep quality, sleep disorders, and specifically also SW and REM sleep behavior disorder (RBD), PD characteristics and severity, was sent to the members of the national PD patients organization in Switzerland. In the study, 36/417 patients (9%) reported SW, of which 22 (5%) had adultonset SW. Patients with SW had significantly longer disease duration (p = 0.035), they reported more often hallucinations (p = 0.004) and nightmares (p = 0.003), and they had higher scores, suggestive for RBD in a validated questionnaire (p = 0.001). Patients with SW were also sleepier (trend to a higher Epworth Sleepiness Scale score, p = 0.055). Our data suggest that SW in PD patients is (1) more common than in the general population, and (2) is associated with RBD, nightmares, and hallucinations. Further studies including polysomnographic recordings are needed to confirm the results of this questionnaire-based analysis, to understand the relationship between SW and other nighttime wandering behaviors in PD, and to clarify the underlying mechanisms.

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“…89 However, while we may have underestimated RBD in our sample, our RBD occurrence rate was similar to other studies using similar methodology. 36,90 In our sample, 28% were using antidepressants, which may result in increased muscle tone during REM sleep. However, EMG score was not significantly different between those taking vs. not taking antidepressants in the entire sample or in any of the RBD groups.…”

mentioning

confidence: 85%

Effects of Sleep Disorders on the Non-Motor Symptoms of Parkinson Disease

Neikrug

Maglione

Liu³

et al. 2013

Journal of Clinical Sleep Medicine

102

106

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Study Objectives: To evaluate the impact of sleep disorders on non-motor symptoms in patients with Parkinson disease (PD). Design: This was a cross-sectional study. Patients with PD were evaluated for obstructive sleep apnea (OSA), restless legs syndrome (RLS), periodic limb movement syndrome (PLMS), and REM sleep behavior disorder (RBD). Cognition was assessed with the Montreal Cognitive Assessment and patients completed self-reported questionnaires assessing non-motor symptoms including depressive symptoms, fatigue, sleep complaints, daytime sleepiness, and quality of life. Setting: Sleep laboratory. Participants: 86 patients with PD (mean age = 67.4 ± 8.8 years; range: 47-89; 29 women). Interventions: N/A. Measurements and Results: Having sleep disorders was a predictor of overall non-motor symptoms in PD (R 2 = 0.33, p < 0.001) while controlling for age, PD severity, and dopaminergic therapy. These analyses revealed that RBD (p = 0.006) and RLS (p = 0.014) were signifi cant predictors of increased non-motor symptoms, but OSA was not. More specifi cally, having a sleep disorder signifi cantly predicted sleep complaints (ΔR 2 = 0.13, p = 0.006), depressive symptoms (ΔR 2 = 0.01, p = 0.03), fatigue (ΔR 2 = 0.12, p = 0.007), poor quality of life (ΔR 2 = 0.13, p = 0.002), and cognitive decline (ΔR 2 = 0.09, p = 0.036). Additionally, increasing number of sleep disorders (0, 1, or ≥ 2 sleep disorders) was a signifi cant contributor to non-motor symptom impairment (R 2 = 0.28, p < 0.001). Conclusion: In this study of PD patients, presence of comorbid sleep disorders predicted more non-motor symptoms including increased sleep complaints, more depressive symptoms, lower quality of life, poorer cognition, and more fatigue. RBD and RLS were factors of overall increased non-motor symptoms, but OSA was not. S C I E N T I F I C I N V E S T I G A T I O N SP arkinson disease (PD) is a progressive neurodegenerative disorder primarily characterized by motor symptoms and increasing motor-related disability, including bradykinesia, rigidity, and tremor.1 Non-motor symptoms (NMS) such as sleep dysfunction, sleepiness, fatigue, pain, and depressive symptoms, are common in PD. In a large multicenter study, NMS were reported by 99% of 1072 PD patients.2 The presentation of NMS in PD is highly variable, and the understanding of such heterogeneity in PD is limited and incomplete.3,4 Chaudhuri et al. 4 suggested that NMS dominate the clinical picture in patients with PD and contribute to the severe disability these patients experience, impair quality of life, and even shorten life expectancy. Studies have suggested that NMS, more than motor symptoms, may impact caregiver distress, quality of life, institutionalization rates, and overall costs related to PD .4-6 A 15-year follow-up study of patients with PD reported that the NMS that did not respond to dopamine therapy (e.g., dementia, sleep disruption) were "more disabling than endof-dose failure or dyskinesia" and were the major cause of morbidity and mortality. Sixty to 98% of pati...

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REM sleep behavior disorder in sleep-disordered patients with versus without Parkinson's disease: is there a need for polysomnography?

Cited by 119 publications

References 18 publications

Sleep Disturbances in Essential Tremor and Parkinson Disease: A Polysomnographic Study

Sleep Disturbances in Essential Tremor and Parkinson Disease: A Polysomnographic Study

Sleepwalking in Parkinson’s disease: a questionnaire-based survey

Effects of Sleep Disorders on the Non-Motor Symptoms of Parkinson Disease

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