Excessive daytime sleepiness and sleep episodes in Japanese patients with Parkinson's disease

Suzuki, Keisuke; Miyamoto, Tomoyuki; Miyamoto, Masayuki; Okuma, Yasuyuki; Hattori, Nobutaka; Kamei, Satoshi; Yoshii, Fumihito; Utsumi, Hiroya; Iwasaki, Yasuo; Iijima, Makoto; Hirata, Koichi

doi:10.1016/j.jns.2008.03.008

Cited by 57 publications

(65 citation statements)

References 39 publications

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“…Except for H&Y stage and DA utilization, we found occurrence of the EDS was not correlated with the UPDRS (disease severity), the PDSS (nocturnal PD symptoms), and the PSQI (Figure 3). Our results supported the notion that EDS represents a separate manifestation of PD and that it is merely dependent on disease rather than on nocturnal disturbance and nighttime sleep problems (Goldman et al., 2013; Suzuki et al., 2008). …”

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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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%

Sleep disturbances in Taiwanese patients with Parkinson's disease

Lin

Chen

et al. 2017

Brain and Behavior

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“…In addition to the impact of nocturnal motor and non-motor symptoms on EDS, a disease-related pathology is thought to contribute to the development of EDS in PD patients (29). We previously studied EDS in patients with PD (30) and found that PD pa- tients with EDS were more likely to exhibit severe disease severity and depressive symptoms and to be on a higher dose of dopaminergic agents than patients without EDS, although no differences in nocturnal disturbances were found.…”

Section: Discussionmentioning

confidence: 99%

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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“…123,136 EDS in these patients is correlated with PD severity, cognitive decline, and longer use of levodopa and dopamine agonists. [137][138][139] Although agonists have been considered to be a major cause of EDS and 'sleep attacks,' it appears that the total load of both types of medications leads to excessive sleepiness in susceptible patients. 140 While the previously described sleep fragmentation would be expected to cause daytime sleepiness, some investigators have failed to find that it is a major cause of EDS in PD compared with age-matched controls.…”

Section: Obstructive Sleep Apneamentioning

confidence: 99%

Non-motor Symptoms in Parkinson’s Disease

Uç¹,

Tippin²,

Chou³

et al. 2011

US Neurology

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In addition to typical motor dysfunction (parkinsonism), diverse non-motor symptoms (NMS) are frequently observed in patients with Parkinsons disease (PD). Some NMS may antedate the diagnosis of PD. Examples of NMS include cognitive impairment, autonomic dysfunction, visual dysfunction, sleep abnormalities, and psychiatric disorders. NMS are associated with wide-ranging abnormalities in extranigral dopaminergic systems and non-dopaminergic (e.g. cholinergic, noradrenergic, serotoninergic) systems. The type and severity of NMS vary based on age, disease severity, and predominant motor symptoms. NMS can be disabling and reduce quality of life. Treatment of NMS can be challenging. Some NMS are helped by dopaminergic treatment, whereas others can be induced or exacerbated by treatments that help the motor dysfunction. Physicians should probe their PD patients about their NMS and address them for better care. Clinical trials should incorporate NMS as outcomes for more meaningful conclusions on the effect of treatments under investigation.

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Excessive daytime sleepiness and sleep episodes in Japanese patients with Parkinson's disease

Cited by 57 publications

References 39 publications

Sleep disturbances in Taiwanese patients with Parkinson's disease

Sleep disturbances in Taiwanese 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

Non-motor Symptoms in Parkinson’s Disease

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