Sleep problems affect quality of life in Parkinson's disease along disease progression

Liguori, Claudio; Cerroni, Rocco; Spanetta, Matteo; Mercuri, Nicola Biagio; Pierantozzi, Mariangela; Pucchio, Alessandra Di

doi:10.1016/j.sleep.2021.02.036

Cited by 21 publications

(16 citation statements)

References 22 publications

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“…In our population, sleep problems were reported in up to 45% of patients, psychiatric symptoms in up to 43%, fatigue in around 25%, and the frequency of gastrointestinal and urinary symptoms ranged from 22 to 24%. Similarly, previous studies have documented a frequency of depression ranging from 10 to 45% (25)(26)(27), anxiety was reported in up to 40% (28)(29)(30), sleep problems in 40-98% of PD patients (16,31,32), fatigue ranged from 33 to 58% (11,33,34) and more than 60% of PD patients complained about urinary symptoms (11,13,24,35). Although patients with motor-fluctuations were exclusively enrolled, the results were consistent with previous studies including both motor fluctuating and non-fluctuating subjects (10)(11)(12)(13).…”

Section: Discussionsupporting

confidence: 89%

“…NMS has been shown to have a strong impact on PD patients' functioning and daily living since they significantly affect daytime activities and impair patients' and caregivers' well-being ( 10 , 12 , 13 ). The main common NMS in PD are depression, anxiety, apathy, sleep disorders, pain, fatigue, autonomic dysfunction, and gastrointestinal disturbances, which can be present in both early and moderate-advanced stages of the disease ( 10 , 12 , 13 , 15 , 16 ). In contrast to the evident motor dysfunction in PD patients, NMS remain often under-recognized in clinical practice, although they are highly common ( 17 , 18 ).…”

Section: Introductionmentioning

confidence: 99%

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Frequency of Non-motor Symptoms in Parkinson's Patients With Motor Fluctuations

et al. 2021

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Background: Non-motor symptoms (NMS), including neuropsychiatric, sleep, autonomic, and sensory domains, are an integral aspect of the clinical presentation of Parkinson disease (PD) and affect neurocognitive functioning as well as patients' and caregivers' well-being.Objective: To describe the occurrence of NMS in PD patients with motor fluctuations in real-life condition.Methods: The present study is a secondary analysis of a previous multinational, multicenter, retrospective-prospective cohort observational study (SYNAPSES). Patients with PD diagnosis and motor fluctuations aged ≥18 years were included. Data collected at the baseline visit were used for this study, and descriptive analyzes were conducted to describe the distribution of NMS in motor-fluctuating PD patients distributed according to different clinical characteristics.Results: Of the 1,610 patients enrolled, 1,589 were included for the analysis (978 males and 611 females), with a mean age of 68.4 (SD = 9.6). Most patients had at least one NMS (88.5%). Sleep problems and psychiatric symptoms were the most prevalent NMS in motor fluctuating PD patients in all H and Y stages. Psychiatric disorders were more frequent in older patients and in patients with a larger number of years of PD diagnosis, while sleep problems were more preeminent in younger patients and with inferior disease duration.Conclusions: The present findings further support the high prevalence of NMS in PD patients with motor fluctuations, thus reinforcing the need for assessing them for diagnostic accuracy and for delivering holistic care.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Frequency of Non-motor Symptoms in Parkinson's Patients With Motor Fluctuations

et al. 2021

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“…Sleep-related symptoms, especially insomnia, are frequently reported by patients with PD, impair their well-being, influence their daily living activities, and aggravate motor functioning [ 2 ]. In support of the importance of maintaining sleep quality and continuity in patients with PD, the concept of sleep benefit has been established several years ago.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep problems are recognized in more than 60% of patients with Parkinson’s disease (PD) and have been related to a worse quality of life (QoL) and greater PD non-motor symptoms (NMS) burden [ 1 , 2 ]. Degenerative processes in the sleep–wake regulatory brainstem centers and hypothalamic nuclei have been proposed as possible causes of sleep-related symptoms in PD [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Among sleep-related symptoms, insomnia is considered a common NMS in PD [ 4 ], which can markedly affect motor symptoms and impair patients’ QoL [ 2 , 4 ]. Moreover, in patients with PD, insomnia has been described more frequently than other sleep disorders and can appear concomitantly with excessive daytime sleepiness (EDS) or rapid eye movement (REM) sleep behavior disorder [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Effects of melatonin prolonged-release on both sleep and motor symptoms in Parkinson’s disease: a preliminary evidence

et al. 2022

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Background Sleep-related symptoms, especially insomnia, are frequently reported by patients with Parkinson’s disease (PD) and can markedly affect motor symptoms and impair patients’ quality of life. Melatonin has been shown to improve sleep in PD patients. This pilot study aimed at evaluating the effects of a 3-month treatment with 2 mg melatonin prolonged-release (PR) on sleep and motor disability in PD patients. Materials and methods Twelve PD patients under stable antiparkinsonian treatment were enrolled in the study. Before treatment (T0), motor dysfunction was assessed with Unified Parkinson’s Disease Rating Scale (UPDRS-III) and sleep architecture with polysomnography. Subjective sleep quality was also assessed through Pittsburgh Sleep Quality Index (PSQI) and daytime somnolence with Epworth Sleepiness Scale (ESS). Patients then started melatonin PR and all measures were repeated at the end of treatment after 3 months (T1). Results Sleep latency significantly decreased from T0 to T1, but no other significant differences were found in PSG parameters. Melatonin PR treatment significantly reduced the ESS scores from T0 to T1, while the PSQI scores presented a trend of improvement from T0 to T1. Motor dysfunction was not improved by melatonin PR, although there was a trend in decreasing UPDRS-III. Both clinical global improvement and patient clinical global impression documented an improvement in insomnia symptoms at T1. Conclusions These findings suggest that melatonin may improve sleep symptoms in PD patients, although further evidence is needed in larger controlled studies to confirm these results and explore the possible direct and indirect influence of sleep improvement on motor dysfunction.

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Correlation of slow‐wave sleep with motor and nonmotor progression in Parkinson's disease

Chen,

Zhao,

Chen

et al. 2023

Ann Clin Transl Neurol

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ObjectiveThis study aimed to explore the association between slow‐wave sleep and the progression of motor and nonmotor symptoms in patients with PD.MethodsData were collected from the Parkinson's Progression Markers Initiative study. Slow‐wave sleep, also known as deep non‐rapid eye movement (DNREM) sleep, was objectively assessed using the Verily Study Watch. Motor function was assessed using the Movement Disorder Society‐Unified Parkinson's Disease Rating Scale Part III score, Hoehn and Yahr stage, freezing of gait, motor fluctuations, and dyskinesia severity. Comprehensive assessments were conducted on nonmotor symptoms, including depression, anxiety, global cognitive function, and autonomic dysfunction. Statistical analyses involved repeated‐measures analysis of variance and linear regression.ResultsA total of 102 patients with PD were included in the study, with a median follow‐up duration of 3.4 years. In the long DNREM sleep duration group (n = 55), better motor function (DNREM × time interaction: F(1,100) = 4.866, p = 0.030), less severe sexual dysfunction (p = 0.026), and improved activities of daily living (p = 0.033) were observed at the last follow‐up visit compared with the short DNREM sleep duration group (n = 47). Reduced DNREM sleep duration is a risk factor for motor progression (β = −0.251, p = 0.021; 95% confidence interval = −0.465 to −0.038).InterpretationThe findings suggest an association between longer DNREM sleep duration and slower motor and nonmotor progression in patients with PD.

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Sleep problems affect quality of life in Parkinson's disease along disease progression

Cited by 21 publications

References 22 publications

Frequency of Non-motor Symptoms in Parkinson's Patients With Motor Fluctuations

Frequency of Non-motor Symptoms in Parkinson's Patients With Motor Fluctuations

Effects of melatonin prolonged-release on both sleep and motor symptoms in Parkinson’s disease: a preliminary evidence

Correlation of slow‐wave sleep with motor and nonmotor progression in Parkinson's disease

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