Snoring and excessive daytime sleepiness in Parkinson's disease

Braga‐Neto, Pedro; Silva‐Júnior, Francisco Pereira da; Monte, Francisca Sueli; Bruin, Pedro Felipe Carvalhedo de; Bruin, Veralice Meireles Sales de

doi:10.1016/j.jns.2003.08.010

Cited by 104 publications

(59 citation statements)

References 38 publications

(26 reference statements)

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“…Table 5 summarizes previously reported studies that evaluated sleep-related breathing disorders in PD patients using questionnaires and/or polysomnography. The comorbid rate of snoring in our study is less frequent than the rates reported in previous studies (16-73%) (4,(7)(8)(9). This may be due to differences in the definitions used to evaluate snoring and in the populations selected for the studies.…”

Section: Discussioncontrasting

confidence: 75%

“…To determine the contributing factors to snoring in PD patients, a forward selection multiple logistic regression analysis was performed that included the HY stage, UPDRS part III, PDQ-39 summary index and PDSS-2 score (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). A second model that included the HY stage, UPDRS part III and PDQ-39 summary index as independent variables was also conducted.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the impact of SRBD on EDS is controversial. Questionnaire-based studies (8,9) have reported that EDS is significantly associated with heavy snoring. Conversely, Arnulf et al (2) studied 54 consecutive patients with PD who were referred for sleepiness and found that 20% of those patients exhibited moderate to severe SAS (apnea-hypopnea index: AHI >15); however, SAS was not correlated with objective sleepiness as measured with the multiple sleep latency test.…”

Section: Introductionmentioning

confidence: 99%

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Snoring is Associated with an Impaired Motor Function, Disease Severity and the Quality of Life but not with Excessive Daytime Sleepiness in Patients with Parkinson's Disease

Suzuki

Miyamoto

et al. 2013

Intern. Med.

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Objective There are conflicting results regarding the frequency and clinical significance of sleep related breathing disorders in patients with Parkinson's disease (PD). The aim of this study was to investigate the relationship between snoring and its clinical correlates in patients with PD. Methods A total of 93 PD patients and 93 controls were analyzed from a previously conducted crosssectional study. Snoring was defined as a snoring frequency of ! 2 days/week (a score of 2 or higher on the PD Sleep Scale-2 subitem 15). Excessive daytime sleepiness (EDS) was defined as an Epworth Sleepiness Scale score of ! 10. Results Snoring was more prevalent in the patients with PD than in the controls (14.0% vs. 1.1%). The PD patients who snored exhibited greater disease severity, worse scores on the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS) and the Parkinson fatigue scale and more impaired scores in several domains of the Parkinson's Disease Questionnaire, including the domains of mobility, activities of daily living, emotional well-being, communication and bodily discomfort, when compared to those who did not snore. No between-group differences were found in EDS. A higher proportion of the UPDRS motor scores for bradykinesia was seen in the PD patients who snored compared to that observed in the PD patients who did not snore. Conclusion We found that snoring was more frequent in PD patients than in controls. Furthermore, snoring in PD patients was associated with disease severity, an impaired motor function and a decreased quality of life, although it was not associated with EDS.

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Section: Discussioncontrasting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Snoring is Associated with an Impaired Motor Function, Disease Severity and the Quality of Life but not with Excessive Daytime Sleepiness in Patients with Parkinson's Disease

Suzuki

Miyamoto

et al. 2013

Intern. Med.

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“…11 Sleep disorders such as obstructive sleep apnea (OSA), restless legs syndrome (RLS), periodic limb movements syndrome (PLMS), and REM sleep behavior disorder (RBD) are commonly reported in patients with PD in rates similar or higher than in the general older adult population. [12][13][14][15][16][17][18][19][20][21][22][23][24][25] Sleep disorders result in complaints about disturbed sleep, excessive daytime sleepiness, cognitive decline, and depression, all of which are also recognized as NMS of PD. [26][27][28][29] Additionally, sleep disorders have been shown to substantially impact healthrelated quality of life in patients with PD.…”

mentioning

confidence: 99%

“…Those studies that did question this relationship primarily assessed RBD, which has been demonstrated to be associated with hallucinations, [31][32][33] cognitive impairment, 34,35 psychiatric comorbidity, 36 increased falls, 36,37 poor emotional functioning, and lower quality of life. 38 Studies looking at OSA in PD had conflicting results, with only one study reporting that OSA was the most important risk factor associated with EDS in PD, 21 while another study reported no relationship with NMS (e.g., sleepiness, depression, and cognitive impairment). 16 Finally, previous findings from our laboratory suggested a relationship between increased periodic leg movements during the night (not associated with arousals), sleep complaints, and poorer quality of life.…”

mentioning

confidence: 99%

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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Sleep Disorders in Parkinson's Disease

Sixel‐Döring

Trenkwalder

2011

Parkinson's Disease

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Snoring and excessive daytime sleepiness in Parkinson's disease

Cited by 104 publications

References 38 publications

Snoring is Associated with an Impaired Motor Function, Disease Severity and the Quality of Life but not with Excessive Daytime Sleepiness in Patients with Parkinson's Disease

Snoring is Associated with an Impaired Motor Function, Disease Severity and the Quality of Life but not with Excessive Daytime Sleepiness in Patients with Parkinson's Disease

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

Sleep Disorders in Parkinson's Disease

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