Hypersomnia in Neurodegenerative Diseases

Bhat, Sushanth; Chokroverty, Sudhansu

doi:10.1016/j.jsmc.2017.03.017

Cited by 15 publications

(7 citation statements)

References 142 publications

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“…Nocturnal problems have a significant impact on PD patients. Previous studies indicated that EDS may be correlated with poor nocturnal sleep, such as restless legs syndrome, nocturnal motor symptoms, and nocturia (46–48). Notably, in our population, we found that the PDSS total and subgroup scores in patients with EDS were lower than those in patients without EDS, and a low PDSS score was related to EDS.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Correlates of Excessive Daytime Sleepiness in Parkinson's Disease

Xiang

Sun

et al. 2019

Front. Neurol.

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Objective: To explore the clinical features and correlates of excessive daytime sleepiness (EDS) in a Chinese population of Parkinson's disease (PD) patients. Methods: Patients with clinically established or clinically probable PD were recruited. Clinical and demographic data were collected, and participants were evaluated using standardized assessment protocols. Patients were divided into PD with EDS and PD without EDS groups based on the Epworth sleepiness scale (ESS) scores, with a cutoff score of 10. Clinical manifestations were compared between patients with and without EDS, and correlates of EDS were also studied. In addition, the relationship between EDS and poor nighttime sleep quality was analyzed. Results: A total of 1,221 PD patients were recruited in our study. The mean ESS (min, max) score was 7.6 ± 6.1 (0, 24), and 34.1% of the patients had ESS scores ≥10. No difference was seen in lifestyle (except for alcohol consumption), environmental factors, BMI, levodopa equivalent dose (LED), initial presentation of motor symptoms, motor subtype, and wearing off between patients with and without EDS. The PD with EDS group had a higher proportion of male patients and a higher average patient age. Moreover, the PD with EDS group showed older age at PD onset, lower educational level, and longer disease duration. Patients with EDS had higher scores on the Hoehn-Yahr scale and the Unified Parkinson's Disease Rating Scale (UPDRS) parts I, II, and III score, more severe non-motor symptoms, and poorer quality of sleep and life. Logistic regression analyses demonstrated that EDS was associated with male sex, age, cognitive impairment, PD-related sleep problems, rapid eye movement sleep behavior disorder (RBD), and worse quality of life (QoL). Conclusion: EDS is a general clinical manifestation in PD, and there were significant differences in clinical features between patients with and without EDS. Moreover, our study proved that many factors were associated with EDS, including male sex, age, cognitive impairment, PD-related sleep problems, RBD, and worse QoL. Understanding the clinical characteristics of EDS in PD patients may help identify EDS early, improve QoL, and reduce the occurrence of accidents.

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Section: Discussionmentioning

confidence: 99%

Clinical Features and Correlates of Excessive Daytime Sleepiness in Parkinson's Disease

Xiang

Sun

et al. 2019

Front. Neurol.

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“…Just two of the present patients displayed excessive sleep. According to a review on hypersomnia, AD patients with sleep apnea and multiple other factors are at risk for hypersomnia, 29 and hypersomnia itself has been associated with physical impairments and the risk of developing AD. 29 The present study had several limitations.…”

Section: Discussionmentioning

confidence: 99%

“…According to a review on hypersomnia, AD patients with sleep apnea and multiple other factors are at risk for hypersomnia, 29 and hypersomnia itself has been associated with physical impairments and the risk of developing AD. 29 The present study had several limitations. First, a clinical diagnostic guideline for sleep disturbances has not been developed, and we used the distribution of sleep parameters to identify a pattern of sleep disturbances.…”

Section: Discussionmentioning

confidence: 99%

High frequency of getting out of bed in patients with Alzheimer's disease monitored by non‐wearable actigraphy

Higami

Yamakawa

Shigenobu

et al. 2018

Geriatrics Gerontology Int

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Aim Sleep disturbances in patients with Alzheimer's disease have not been systematically evaluated, because sleep monitoring has proved difficult. Our goal was to quantitatively characterize sleep disturbances in patients with Alzheimer's disease. Methods The present study was a cross‐sectional descriptive study, carried out in dementia care units in Japan. Participants were 63 patients with Alzheimer's disease (mean age 77.6 ± 8.0 years) with severe behavioral and psychological symptoms of dementia. A non‐wearable actigraphy device placed under patient mattresses was used to measure sleep parameters: sleep time, time in bed, number of wakings and number of times they left the bed. Cut‐off points for sleep parameters were based on the interquartile range of the data. Results Median nocturnal sleep time was 6.2 h (interquartile range 2.7 h). Median frequency of waking was eight times (5)/night. Median frequency of leaving the bed was five times (6), with a maximum of 31/night. We identified three types of sleep disturbance: frequent bed leaving, short sleep time and excessive sleep time. Multiple linear regression showed that duration of dementia was a significant predictor of frequent bed leaving at night (P = 0.042). Conclusions Frequent bed leaving at night reflects severe sleep deprivation in patients with mild‐to‐severe Alzheimer's disease. Safety measures are required to prevent accidents related to sleep disturbances, regardless of dementia severity. Geriatr Gerontol Int 2019; 19: 130–134.

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“…[ 32 ] Many coexistent primary sleep disorders (e.g., restless legs syndrome [RLS], periodic limb movement disorder, and RBD), motor disturbances (e.g., nocturnal akinesia, bradykinesia, rest tremor, and inability to turn over in bed), and other nonmotor symptoms (i.e., pain, depression, nocturia, and hallucinations, temperature dysregulation due to dysautonomia) could also lead to sleep fragmentation, which in turn could result in EDS. [ 33 34 35 ] In particular, the presence of RBD might be associated with greater sleepiness in PD, as some studies reported that PD patients with EDS had a higher rate of RBD than those without EDS and that PD patients with probable RBD experienced a higher level of sleepiness than those without RBD. [ 36 37 38 ] It is unclear whether RLS directly contributes to EDS.…”

Section: E Tiologymentioning

confidence: 99%

Excessive Daytime Sleepiness in Parkinson's Disease

Shen

Huang

et al. 2018

Chinese Medical Journal

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Objective:Excessive daytime sleepiness (EDS) is one of the most common sleep abnormalities in patients with Parkinson's disease (PD), yet its multifactorial etiology complicates its treatment. This review summarized recent studies on the epidemiology, etiology, clinical implications, associated features, and evaluation of EDS in PD. The efficacy of pharmacologic and non-pharmacologic treatments for EDS in PD was also reviewed.Data Sources:English language articles indexed in PubMed and Cochrane databases and Chinese-language papers indexed in Wanfang and National Knowledge Infrastructure databases that were published between January 1987 and November 2017 were located using the following search terms: “sleepiness”, “sleep and Parkinson's disease”, and “Parkinson's disease and treatment”.Study Selection:Original research articles and critical reviews related to EDS in PD were selected.Results:EDS is a major health hazard and is associated with many motor and nonmotor symptoms of PD. Its causes are multifactorial. There are few specific guidelines for the treatment of EDS in PD. It is first necessary to identify and treat any possible factors causing EDS. Recent studies showed that some nonpharmacologic (i.e., cognitive behavioral therapy, light therapy, and repetitive transcranial magnetic stimulation) and pharmacologic (i.e., modafinil, methylphenidate, caffeine, istradefylline, sodium oxybate, and atomoxetine) treatments may be effective in treating EDS in PD.Conclusions:EDS is common in the PD population and can have an immensely negative impact on quality of life. Its causes are multifactorial, which complicates its treatment. Further investigations are required to determine the safety and efficacy of potential therapies and to develop novel treatment approaches for EDS in PD.

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Hypersomnia in Neurodegenerative Diseases

Cited by 15 publications

References 142 publications

Clinical Features and Correlates of Excessive Daytime Sleepiness in Parkinson's Disease

Clinical Features and Correlates of Excessive Daytime Sleepiness in Parkinson's Disease

High frequency of getting out of bed in patients with Alzheimer's disease monitored by non‐wearable actigraphy

Excessive Daytime Sleepiness in Parkinson's Disease

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