Evaluation of somnolence in Parkinson’s disease: Comparison with age- and sex-matched controls

Tan, Eng‐King; Lum, S.Y.; Fook‐Chong, S.; Teoh, Mei Lin; Yuen, Yin; Tan, Lenny; Tan, Angelina D.; Wong, Michael

doi:10.1212/wnl.58.3.465

Cited by 163 publications

(120 citation statements)

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“…The occurrence of EDS among patients with PD was lower in Asian than in Caucasian populations in the literature. Studies from Asia using the ESS have reported that the prevalence of EDS ranged from 15.1% to 32.3%; however, prevalence ranging from 40.6% to 57% was reported for Europe and North America (Brodsky et al., 2003; Chen et al., 2015; Goldman et al., 2013; Hobson et al., 2002; Louter et al., 2012; Poryazova et al., 2010; Ratti et al., 2015; Setthawatcharawanich et al., 2014; Tan et al., 2002; Yu et al., 2015; Zhu et al., 2016) (Table 3). Disease severity, disease duration, dopaminergic therapy, and hypnotic medication have been suggested to contribute to EDS; however, neither of them could fully explain this discrepancy.…”

Section: Discussionmentioning

confidence: 99%

“…Disease severity, disease duration, dopaminergic therapy, and hypnotic medication have been suggested to contribute to EDS; however, neither of them could fully explain this discrepancy. The disease severity of the patients were similar in these Western and Asian studies, with H&Y stages between 2 and 3 (Poryazova et al., 2010; Setthawatcharawanich et al., 2014; Tan et al., 2002; Yu et al., 2015; Zhu et al., 2016). In a study of 638 Canadian patients with PD with H&Y stage of 2.2 ± 0.68, Hobson et al.…”

Section: Discussionmentioning

confidence: 99%

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Sleep disturbances in Taiwanese patients with Parkinson's disease

Lin

Chen

et al. 2017

Brain and Behavior

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IntroductionSleep disturbance is a common nonmotor symptom of Parkinson's disease (PD) and strongly affects patients’ quality of life. The relationship between excessive daytime sleepiness (EDS) and nighttime problems remains uncertain. Arguments persist regarding the risk factors for sleep disturbance among patients with PD. Furthermore, the prevalence of EDS appears to be lower in Asian countries. Herein, we conducted the study to describe the characteristics of sleep problems in a sample of Taiwanese PD patients and delineate the difference with reported sleep disturbances in Caucasian PD patients from the literature.MethodsPatients with PD were recruited from the outpatient clinic of a tertiary medical center and were evaluated using standardized assessment protocols, including the Parkinson's Disease Sleep Scale (PDSS), the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and 39‐Item Parkinson's Disease Questionnaire (PDQ‐39).ResultsA total of 225 patients with PD were recruited. The mean age of patients with PD was 65.7 years old and the mean disease duration was 8.18 years. Among the patients, 53.8% were defined as poor sleepers (PSQI > 5) and 26.3% had EDS. Seventy‐one percent of the poor sleepers used hypnotic medications. The poor sleepers were worse in the scores of Unified Parkinson's Disease Rating Scale (UPDRS), PDSS, and the PDQ‐39, and received higher levodopa daily dosage. A PDSS score of <126 indicate that a patient with PD was a poor sleeper. EDS was positively correlated with advanced Hoehn and Yahr stages and use of dopamine agonists but not with levodopa daily dosage and levodopa equivalent daily dosage.ConclusionsTaiwanese patients with PD had a lower prevalence of EDS compared with the literatures reported in Caucasian patients. We identify and suggest that PDSS total score, rather than subcategory items, should be used to predict poor sleep among patients with PD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sleep disturbances in Taiwanese patients with Parkinson's disease

Lin

Chen

et al. 2017

Brain and Behavior

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“…Twenty-four had a symptomatic RBD, 11 of which had PD [12]. In questionnaire-based studies asking for sleepwalking/nighttime wandering in PD patients, frequencies ranging from 2% (4/201) [13], 3% (2/61, resp. 2/66) [9,14] to 5% (16/303) [15] can be found in the literature, however, no detailed characteristics of the phenomenon were studied.…”

Section: Introductionmentioning

confidence: 99%

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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“…Elevated Epworth Sleep Scale (ESS) scores, male gender, long duration and severity of the disease are the major risks for EDS [22]. Several studies indicated that dopaminergic load acts as a correlative factor for a higher ESS score and increased daytime sleepiness in PD [23,24]. In addition, Yi PL et al proved that IL-1b in the hypothalamus mediates the EDS in the rotenone rat model and that the TNF-NF-jB signaling is involved in another hemiparkinsonian rat model [25,26].…”

Section: Sleep Disordersmentioning

confidence: 99%

A New Perspective for Parkinson’s Disease: Circadian Rhythm

Wang

et al. 2016

Neurosci. Bull.

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Circadian rhythm is manifested by the behavioral and physiological changes from day to night, which is controlled by the pacemaker and its regulator. The former is located at the suprachiasmatic nuclei (SCN) in the anterior hypothalamus, while the latter is composed of clock genes present in all tissues. Circadian desynchronization influences normal patterns of day-night rhythms such as sleep and alertness cycles, rest and activity cycles. Parkinson's disease (PD) exhibits diurnal fluctuations. Circadian dysfunction has been observed in PD patients and animal models, which may result in negative consequences to the homeostasis and even exacerbate the disease progression. Therefore, circadian therapies, including light stimulation, physical activity, dietary and social schedules, may be helpful for PD patients. However, the cellular and molecular mechanisms that underlie the circadian dysfunction in PD remain elusive. Further research on circadian patterns is needed. This article summarizes the existing research on the circadian rhythms in PD, focusing on the clinical symptom variations, molecular changes, as well as the available treatment options.

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Evaluation of somnolence in Parkinson’s disease: Comparison with age- and sex-matched controls

Cited by 163 publications

References 10 publications

Sleep disturbances in Taiwanese patients with Parkinson's disease

Sleep disturbances in Taiwanese patients with Parkinson's disease

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

A New Perspective for Parkinson’s Disease: Circadian Rhythm

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