Management Recommendations on Sleep Disturbance of Patients with Parkinson's Disease

Liu, Chunfeng; Wang, Tao; Zhan, Shuqin; Geng, Deqin; Wang, Jian; Li, Jun; Shang, Huifang; Wang, Limin; Chan, Piu; Chen, Haibo; Chen, Shengdi; Wang, Yuping; Zhi-gang, Zhao

doi:10.4103/0366-6999.247210

Cited by 31 publications

(33 citation statements)

References 80 publications

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“…RBD is associated with longer disease duration, motor fluctuations, psychiatric comorbidities, and higher doses of levodopa in PD patients 6,7 . RBD can be a prodromal symptom of PD and can be used for diagnosis of PD at an early stage 1,2,7,8 . Furthermore, sleep disorders are observed throughout the course of PD.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, sleep disorders are observed throughout the course of PD. Nighttime problems and EDS significantly reduce the quality of life in patients with advanced PD, and require prompt recognition and intervention 1,2,7 . Clinical subtypes of sleep disorders may even constitute distinct phenotypes of PD.…”

Section: Introductionmentioning

confidence: 99%

“…Parkinson’s disease (PD) is a movement disorder. Sleep disorders, such as nighttime problems, excessive daytime sleepiness (EDS), rapid eye movement sleep behavior disorder (RBD), and restless legs syndrome (RLS) are commonly reported in patients with PD 1 – 3 . The pathophysiology of sleep disorders associated with dopaminergic and non-dopaminergic mechanisms during the course of PD and the sleep disorder type impart different effects on PD patients 4 .…”

Section: Introductionmentioning

confidence: 99%

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Multiple comorbid sleep disorders adversely affect quality of life in Parkinson’s disease patients

Zhang

Zhao

Huang

et al. 2020

npj Parkinsons Dis.

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Sleep disorders are common non-motor symptoms in patients with Parkinson’s disease (PD). The characteristics and impact of multiple comorbid sleep disorders remain to be elucidated. Our goal was to investigate the characteristics of various sleep disorder comorbidities, and their association with motor complications and the impact on the quality of life in PD patients. In this multicenter, observational, cross-sectional study, data concerning the clinical characteristics of complicated sleep disorders were collected from PD patients treated at 40 different hospitals in Shanghai. Sleep disorders were evaluated using the PD Sleep Scale-2, Epworth Sleepiness Scale, Rapid Eye Movement Sleep Behavior Disorder Questionnaire-Hong Kong, and the International Restless Legs Scale. Among the 1006 subjects evaluated, 77.53% exhibited signs of sleep disorders, and most had multiple sleep disorders (n = 502, 49.9%). A smaller percentage of patients with sleep disorders had a single disorder (n = 278, 27.6%). Furthermore, an increased number of sleep disorders, including nighttime problems, excessive daytime sleepiness, rapid eye movement sleep behavior disorder, and restless legs syndrome was a significant contributor to a poor quality of life (β = 4.33, CI: 3.33–5.33, P for trend <0.001), even when controlling for multiple factors. Moreover, motor complications partially mediated this relationship (indirect effect: β = 0.355, 95% boot CI: 0.134, 0.652).Our study showed that a large proportion of PD patients suffer from multiple comorbid sleep disorders, which greatly decreases the quality of life in PD patients and is partially mediated by motor complications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Multiple comorbid sleep disorders adversely affect quality of life in Parkinson’s disease patients

Zhang

Zhao

Huang

et al. 2020

npj Parkinsons Dis.

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“…[3] Therefore, sleep disorders are not rare in patients with PD, which require increased attention from researchers and clinicians. [4] In recent years, there have been major advances in our understanding of the relationship between sleep disorders and PD, yet many questions remain unanswered. [5,6] Sleep disorder-specific mechanisms in PD are unknown, but may be associated with latent neural degeneration, motor and non-motor dysfunction, and dopamine replacement therapy.…”

Section: Introductionmentioning

confidence: 99%

Sleep fragmentation as an important clinical characteristic of sleep disorders in Parkinson's disease

Cai

Luo

Chen

et al. 2019

Chinese Medical Journal

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Background:Sleep disorders are one of the earliest non-motor symptoms of Parkinson's disease (PD). Sleep disorders could, therefore, have value for recognition and diagnosis in PD. However, no unified classification and diagnostic criteria exist to evaluate sleep disorders by polysomnography (PSG). Utilizing PSG to monitor sleep processes of patients with PD and analyze sleep disorder characteristics and their relationship with demographic parameters could aid in bridging this gap. This preliminary study aimed to evaluate the clinical characteristic of sleep disorders in PD using PSG.Methods:PSG was used to evaluate sleep disorders in 27 patients with PD and 20 healthy volunteers between August 2015 and July 2018 in Fujian Medical University Union Hospital. Total sleep time (TST), sleep efficiency (SE), total wake time, and other parameters were compared between the two groups. Finally, the correlation between sleep disorders and age, disease duration, Unified Parkinson's Disease Rating Scale-III scores, Hoehn-Yahr stage, and levodopa dose were analyzed. The main statistical methods included Chi-square test, two independent samples t test, Fisher exact test, and Pearson correlation.Results:Sleep fragmentation in the PD group was significantly increased (74.1%) while difficulty falling asleep and early awakening were not, as compared to healthy controls. No significant differences were found in time in bed, sleep latency (SL), non-rapid eye movement (NREM) stage 1 (N1), N1%, N2, N2%, N3%, and NREM% between PD and control groups; but TST (327.96 ± 105.26 min vs. 414.67 ± 78.31 min, P = 0.003), SE (63.26% ± 14.83% vs. 76.8% ± 11.57%, P = 0.001), R N3 (20.00 [39.00] min vs. 61.50 [48.87] min, P = 0.001), NREM (262.59 ± 91.20 min vs. 337.17 ± 63.47 min, P = 0.003), rapid-eye-movement (REM) (32.50 [33.00] min vs. 85.25 [32.12] min, P < 0.001), REM% (9.56 ± 6.01 vs. 15.50 ± 4.81, P = 0.001), REM sleep latency (157.89 ± 99.04 min vs. 103.47 ± 71.70 min, P = 0.034) were significantly reduced in PD group.Conclusion:This preliminary study supported that sleep fragmentation was an important clinical characteristic of sleep disorders in PD. Whether sleep fragmentation is a potential quantifiable marker in PD needs to be further investigated in the future study.

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“…Such nocturnal non-motor symptoms may arise for multiple reasons. Firstly, different with motor symptoms improved by dopaminergic drugs, nocturnal symptoms become more prevalent with disease progression [7,22] but improvement by dopaminergic drugs is limit. Thus, attentions for improvement of non-motor symptoms are growing [23].…”

Section: Discussionmentioning

confidence: 99%

Social Listening – Revealing Parkinson’s Disease over Day and Night

Zhang¹,

Meng²,

Li³

et al. 2020

Preprint

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Background: Nocturnal symptoms in Parkinson’s disease and their related burdens on patients are often treated after management of daytime manifestations. In order to better understand the unmet needs of nocturnal symptoms management, we sought to analyze the characteristics of nocturnal symptoms and the burden of nocturnal-occurring motor and non-motor symptoms from patients’ perspectives.Methods: We used a contemporary Social Listening big-data technique to analyze large amounts of Parkinson’s disease symptoms in patient-doctor and patient-patient dialogues available from social media platforms in China. Frequency of nocturnal symptoms as a proportion of total dialogues per year and their relative negative sentiment were analyzed. As a contrast, overall symptoms (occurring at day or night) were also analyzed. Results: We found that share of voice for overall motor symptoms did not increase from 2016 to 2018 (79%, p = 0.5), but share of voice for non-motor symptoms was 69% in 2018, growing by 7% (p < 0.01), and motor complications was 9%, growing by 6% (p < 0.01), respectively. For nocturnal symptoms, 45% of the analyzed PD population reported nocturnal symptoms in 2018, growing by 6% from 2016 (p < 0.01). Share of voice for nocturnal-occurring motor symptoms was higher than non-motor symptoms. Non-motor symptoms evoked higher negative sentiment no matter whether they occurred during the day or night. For symptoms that can occur at either day or night, each nocturnal symptom was rated with a higher negative sentiment score than the same symptom during the day, regardless of the type of symptom (motor, non-motor, or motor complication).Conclusions: The growing share of voice and the greater negative sentiment of nocturnal symptoms from patients’ perspectives suggest that management of nocturnal symptoms is an unmet need of patients with Parkinson’s disease. A greater emphasis on detecting nocturnal symptoms and treating them with 24-hour care is encouraged.

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Management Recommendations on Sleep Disturbance of Patients with Parkinson's Disease

Cited by 31 publications

References 80 publications

Multiple comorbid sleep disorders adversely affect quality of life in Parkinson’s disease patients

Multiple comorbid sleep disorders adversely affect quality of life in Parkinson’s disease patients

Sleep fragmentation as an important clinical characteristic of sleep disorders in Parkinson's disease

Social Listening – Revealing Parkinson’s Disease over Day and Night

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