Is obstructive sleep apnea a problem in Parkinson’s disease?

Objective: Sleep disorders in Parkinson's disease are very common. Polysomnography (PSG) is considered the gold standard for diagnosis. The aim of the present study is to assess the prevalence of nocturnal sleep disorders diagnosed by polysomnography and to determine the associated clinical factors. Method: A total of 120 patients with Parkinson's disease were included. All patients underwent a standardized overnight, single night polysomnography. Results: Ninety-four (78.3%) patients had an abnormal PSG. Half of the patients fulfilled criteria for sleep apnea-hypopnea syndrome (SAHS); rapid eye movement behavior disorder (RBD) was present in 37.5%. Characteristics associated with SAHS were age (p = 0.049) and body mass index (p = 0.016). Regarding RBD, age (p , 0.001), left motor onset (p = 0.047) and levodopa equivalent dose (p = 0.002) were the main predictors. Conclusion: SAHS and RBD were the most frequent sleep disorders. Higher levodopa equivalent dose and body mass index appear to be risk factors for RBD and SAHS, respectively.Keywords: Parkinson's disease, sleep disorders, polysomnography. RESUMOObjetivo: Os distúrbios do sono na doença de Parkinson são muito comuns. A polissonografia é considerada o padrão-ouro para o diagnóstico. O objetivo do presente estudo é avaliar a prevalência de distúrbios de sono noturno diagnosticados por polissonografia. Método: 120 pacientes com doença de Parkinson foram incluídos. Todos os pacientes foram submetidos a uma única noite, polissonografia de noite. Resultados: 94 (78,3%) pacientes tiveram uma polissonografia anormal e 50% preencheram a síndrome da apneia e hipopneia do sono (SAHOS); distúrbio de comportamento do movimento rápido dos olhos (RBD) esteve presente em 37,5%. As características associadas com SAHOS foram idade (p = 0,049) e índice de massa corporal (p = 0,016). Quanto RBD, idade (p , 0,001), deixou início motor (p = 0,047) e levodopa dose equivalente (p = 0,002) foram os preditores. Conclusão: SAHOS e RBD foram os distúrbios do sono mais frequente. Dose superior equivalente de levodopa e índice de massa corporal parecem ser fatores de risco, respectivamente.Palavras-chave: doença de Parkinson, distúrbios do sono, polissonografia.

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“…Reports on the frequency of this disorder ranges from 27% to 60% 3,24,25 . Predictors of SAHS in our sample were an older age and higher BMI.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Alatriste-Booth

Rodríguez-Violante

Camacho-Ordóñez

et al. 2015

Arq. Neuro-Psiquiatr.

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“…Contradictory evidence can be found showing both a higher prevalence of OSA in PD patients than in the general population [67,149,151] and no increased risk of OSA in PD patients [152,153]. Studies suggest a relationship between daytime sleepiness and OSA in PD [67,154].…”

Section: Sleep Disordersmentioning

confidence: 99%

“…Studies suggest a relationship between daytime sleepiness and OSA in PD [67,154]. Conversely, findings have also shown no relationship between daytime sleepiness and OSA in PD [152,153]. In fact, very few studies about sleep in PD involved polysomnography.…”

Section: Sleep Disordersmentioning

confidence: 99%

Sleep-Wake Disturbances in Parkinson’s Disease: Current Evidence regarding Diagnostic and Therapeutic Decisions

Bruin

Bittencourt²,

Tufik³

2012

Eur Neurol

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Sleep disorders have been frequently reported in patients with Parkinson’s disease (PD). However, there is insufficient evidence to guide precise recommendations on some diagnostic and treatment strategies. Here, we review clinical studies dealing with sleep abnormalities in PD and present clinical recommendations. Previous studies describing insomnia, excessive daytime sleepiness, narcolepsy-like episodes, circadian changes, sleep-disordered breathing, rapid eye movement sleep behavior disorder, vivid dreams and restless legs syndrome are evaluated. Longitudinal studies associating sleep disorders with PD onset or clinical deterioration are rare: only one longitudinal study associated daytime sleepiness with PD onset. Evidence suggests that clinical investigations must include direct questioning about depressive symptoms, nocturnal cramps, pain, nocturia and nighttime off periods. A patient interview must be conducted regarding sleep symptoms, including nightmares, abnormal behavior during sleep, snoring, restless legs syndrome and daytime sleepiness. Initial evidence indicates that light therapy improves motor function and depression. Advice on sleep hygiene, the treatment of concomitant depression and the careful use of dopaminergic drugs and hypnosedative agents should be considered. To date, very few controlled studies are available to make a recommendation for the management of sleep-wake disturbances in PD.

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“…In one of the largest non-motor symptoms surveys in PD, the frequency of sleep disorders varied between 48-82 %, increasing with PD severity [1]. Common sleep disorders in PD patients include obstructive sleep apnea (OSA), for which the prevalence is thought to be 20-60 % [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Although some studies showed an increased prevalence of OSA in PD patients [5,4], others reported similar or lower rates to those in the general population [3,6]. OSA is common in the general population and, when untreated, can cause important neurocognitive dysfunction, cardiovascular complications, and metabolic disorders [7].…”

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea in Parkinson’s disease patients: effect of Sinemet CR taken at bedtime

et al. 2015

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Is obstructive sleep apnea a problem in Parkinson’s disease?

Cited by 189 publications

References 24 publications

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Sleep-Wake Disturbances in Parkinson’s Disease: Current Evidence regarding Diagnostic and Therapeutic Decisions

Obstructive sleep apnea in Parkinson’s disease patients: effect of Sinemet CR taken at bedtime

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