Sleep apnea syndrome in Parkinson's disease. A case–control study in 49 patients

Diederich, Nico J.; Vaillant, Michel; Leischen, Mike; Mancuso, Giovanna; Golinval, Serge; Nati, Romain; Schlesser, Marc

doi:10.1002/mds.20624

Cited by 141 publications

(124 citation statements)

References 16 publications

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“…In previous studies conducted by Cochen de Cock and Diederich et al, the mean and minimal oxygen saturations were higher in PD patients than in controls. 31,32 Additionally, OSAS was significantly more prevalent in the control compared with the PD group. However, our study found no difference between the prevalence of OSAS in the ET and PD groups.…”

Section: Discussionmentioning

confidence: 93%

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: Discussionmentioning

confidence: 93%

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

Barut

Taşçılar

Varo

2015

Journal of Clinical Sleep Medicine

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“…Further, a cohort study suggested that obstructive sleep apnea hypopnea syndrome occurred in up to 83% of patients with uncontrolled hypertension despite them taking three or more antihypertensive agents at the optimum doses (Logan et al 2001). Sleep dysfunction including sleep apnea is also observed in patients with Parkinson disease (Diederich et al 2005). Considering all these findings collectively, the results of our study indicate that alterations in respiratory pattern caused by sleep apnea affect HRV, and it is therefore very important to assess respiration in older patients and in patients with respiratory disturbance before evaluating autonomic regulation of the heart using spectral HRV analysis.…”

Section: Discussionmentioning

confidence: 99%

Consciously Controlled Breathing Decreases the High-Frequency Component of Heart Rate Variability by Inhibiting Cardiac Parasympathetic Nerve Activity

Sasaki

Maruyama

2014

Tohoku J. Exp. Med.

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Heart rate variability (HRV), the beat-to-beat alterations in heart rate, comprises sympathetic and parasympathetic nerve activities of the heart. HRV analysis is used to quantify cardiac autonomic regulation. Since respiration could be a confounding factor in HRV evaluation, some studies recommend consciously controlled breathing to standardize the method. However, it remains unclear whether controlled breathing affects HRV measurement. We compared the effects of controlled breathing on HRV with those of spontaneous breathing. In 20 healthy volunteers, we measured respiratory frequency (f), tidal volume, and blood pressure (BP) and recorded electrocardiograms during spontaneous breathing (14.8 ± 0.7 breaths/min) and controlled breathing at 15 (0.25 Hz) and 6 (0.10 Hz) breaths/min. Compared to spontaneous breathing, controlled breathing at 0.25 Hz showed a higher heart rate and a lower highfrequency (HF) component, an index of parasympathetic nerve activity, although the f was the same. During controlled breathing at 0.10 Hz, the ratio of the low frequency (LF) to HF components (LF/HF), an index of sympathetic nerve activity, increased greatly and HF decreased, while heart rate and BP remained almost unchanged. Thus, controlled breathing at 0.25 Hz, which requires mental concentration, might inhibit parasympathetic nerve activity. During controlled breathing at 0.10 Hz, LF/HF increases because some HF subcomponents are synchronized with f and probably move into the LF band. This increment leads to misinterpretation of the true autonomic nervous regulation. We recommend that the respiratory pattern of participants should be evaluated before spectral HRV analysis to correctly understand changes in autonomic nervous regulation.

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“…A previous study found OSA in 43% of 49 PD patients and implicated OSA as a cause of daytime sleepiness and tiredness. 38 The OSA may arise in part from upper airway muscle dysfunction caused by nocturnal akinesia or dyskinesia. However, a recent report suggested that the frequency of OSA in PD is not different from that seen in the general population.…”

Section: Discussionmentioning

confidence: 99%

Insomnia and Sleepiness in Parkinson Disease: Associations with Symptoms and Comorbidities

Chung

Bohnen

Albin

et al. 2013

Journal of Clinical Sleep Medicine

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Study Objectives: Insomnia and daytime sleepiness are common complaints in Parkinson disease (PD), but the main causes remain unclear. We examined the potential impact of both motor and non-motor symptoms of PD on sleep problems. Methods: Patients with PD (n = 128) were assessed using the Insomnia Severity Index, Epworth Sleepiness Scale, Unifi ed Parkinson Disease Rating Scale, Beck Depression Inventory, Fatigue Severity Scale, Survey of Autonomic Symptoms, and the 39-item Parkinson Disease Questionnaire. A subset of subjects (n = 38, 30%) also completed nocturnal polysomnography and a multiple sleep latency test (MSLT) S C I E N T I F I C I N V E S T I G A T I O N SS leep-related disturbances, including insomnia and excessive daytime sleepiness, are some of the most common complaints of patients with Parkinson disease (PD). As many as 60% to 76% of PD patients experience insomnia.1,2 Nocturnal hypokinesia, nocturnal and early morning dystonia, and impaired bed mobility are thought to be common causes.2,3 In practice, attention often focuses on motor symptoms of PD, and these are probably considered fi rst as possible causes of sleep disturbance. Although non-motor symptoms, such as depressed mood, anxiety, pain, or frequent nocturia tend to receive less clinical consideration, such symptoms could have substantial impact on sleep. 4 In particular, depression is the most common psychiatric problem in PD, with an estimated prevalence of 17% to 50%, 5,6 depending on the rating scales or structured clinical diagnosis used to identify the problem. Several studies have examined the relationship between depressed mood and sleep disturbance in PD patients. 7 The relative contributions, however, of motor and non-motor features to sleep disturbance remains unclear, despite the important impact that sleep disturbance can have on quality of life in patients with PD. Furthermore, the potential value of objective sleep laboratory data, in understanding sleep-related complaints in PD, remains unclear. The main objective of this study was to examine associations of both motor and non-motor PD symptoms with reported sleep problems. We hypothesized that non-motor and motor symptoms of PD patients would each show independent association with subjective insomnia or daytime sleepiness. In a subset of patients, we also assessed the extent to which polysomnography and the multiple sleep latency test (MSLT) may help to understand sleep complaints in PD. BRIEF SUMMARYCurrent Knowledge/Study Rationale: Sleep disturbance and daytime somnolence are common complaints in patients with Parkinson disease (PD), but the main causes remain unclear. This study was done to explore associations between sleep-related complaints and potential contributors, including both motor and non-motor PD symptoms. Study Impact: Non-motor features of PD, such as mild depressive symptoms, fatigue, and autonomic symptoms, are associated with subjective insomnia, whereas fatigue and dopaminergic medication dose are associated with subjective daytime sleepiness. I...

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Sleep apnea syndrome in Parkinson's disease. A case–control study in 49 patients

Cited by 141 publications

References 16 publications

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

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

Consciously Controlled Breathing Decreases the High-Frequency Component of Heart Rate Variability by Inhibiting Cardiac Parasympathetic Nerve Activity

Insomnia and Sleepiness in Parkinson Disease: Associations with Symptoms and Comorbidities

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