Sleep Disturbances and Associated Factors in Drug-Naïve Patients with Parkinson’s Disease

Abstract

Purpose Sleep disturbance is one of the common symptoms in Parkinson’s disease (PD). The study of sleep disturbance used to concentrate on treated PD. This study aimed to investigate the factors that are associated with the sleep quality of drug-naïve patients with PD. Patients and Methods All participants were interviewed using a standard questionnaire to collect basic information. PD severity, depression symptoms, anxiety symptoms, sleep quality, cognitive status, life quality, and the presence of rapid eye movement (REM) sleep behavior disorder (RBD) and minor hallucination were assessed using corresponding rating scales. The patients with a Pittsburgh Sleep Quality Index score ≤6 fell into the poor sleep group, and those with REM Sleep Behavior Disorder Screening Questionnaire score ≥5 were considered to have probable RBD. Results Seventy drug-naive patients with PD and 30 healthy controls matched for age, sex, and education were recruited. Up to 41.4% of the patients suffered from sleep disturbance, and 24.3% of the patients had RBD. Poor sleepers were more likely to have left-side predominant motor symptoms. Compared with good sleepers, poor sleepers, particularly female patients, had more burden in the aspect of anxiety and depression. RBD was associated with more nonmotor symptoms, poor sleep quality, bad performance in cognition orientation domain, anxiety, depression, presence of minor hallucination, and poor life quality. Conclusion Sleep disturbances are common in drug-naïve PD and require wide attention. Motor symptom laterality and gender difference in mood are associated with sleep quality. Depression, anxiety, and RBD are highly related to sleep disturbance. RBD has many comorbidities, which can influence the cognitive function and life quality of the patients.

Prevalence and Influencing Factors of Depression in Patients with Parkinson’s Disease

“…Low sleep status score, daily use of levodopa, high Hoehn and Yahr stage, high UPDRS II score, and high UPDRS III score were risk factors for depression in these PD patients. Clinical research 24 has found that 67%-98% of PD patients have a sleep disorder, and sleep disorders are the main cause of daytime sleepiness and cognitive impairment, which have significant adverse effects on a patient’s daily life and psychological state. Therefore, sleep disorders are speculated to be associated with depression in PD patients, and a later study confirmed that sleep status scores are negatively correlated with depression.…”

Chronobiology of Parkinson's disease: Past, present and future

“…Alterations in melatonin rhythmicity are also implicated in RBD in PD (Weissov a et al, 2018): Although some studies have failed to observe a significant difference in the 24-h melatonin rhythm between RBD patients and healthy controls (Breen et al, 2014), other results indicate that melatonin rhythmicity differs between PD/RBD patients and controls in that the melatonin rhythm is delayed by approximately 2 h, in parallel with a 1 h delay in habitual sleep phase (Weissov a et al, 2018). These findings suggest that previously reported inconsistent findings regarding alteration in the circadian phase in PD as derived from DLMO or core body measurements (Bolitho et al, 2014;Videnovic et al, 2014;Zhong et al, 2021) may be partly due to differing clinical characteristics of the cohorts examined in terms of medication status, disease severity and presence of RBD.…”