Sleep Dysfunction in Parkinson's Disease

Selvaraj, Vinoth Kanna; Keshavamurthy, Bhanu

doi:10.7860/jcdr/2016/16446.7208

Cited by 22 publications

(29 citation statements)

References 24 publications

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“…[ 31 ] from Chandigarh, sleep disturbances were reported in 98% of drug-naïve patients with Parkinson's disease. Sleep disturbances were reported in 70% of patients as per Se lvaraj and Keshavamurthy[ 32 ] from Chennai. As per Kumar et al .…”

Section: Discussionmentioning

confidence: 99%

Quality of Sleep and Sleep Disorders in Patients with Parkinsonism: A Polysomnography Based Study from Rural South India

Jasti

Mallipeddi

Apparao

et al. 2018

Journal of Neurosciences in Rural Practice

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Objective:The objective of this study is to study the quality of sleep, sleep disorders, and polysomnographic profile in Parkinsonism patients from rural areas and to correlate polysomnographic profile with the staging of disease and with sleep questionnaire.Materials and Methods:Between May 2014 and December 2015, 168 Parkinsonism patients were prospectively screened using sleep questionnaire; Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Parkinson Disease Sleep Score-2 (PDSS-2). Sixty patients underwent overnight polysomnography subsequently.Results:The mean age of 168 patients in the study was 65.3 ± 12.8 years. The mean duration of Parkinsonism was 4.6 ± 3.1 years. The mean ESS, PSQI and PDSS-2 were 12.4 ± 3.2, 7.9 ± 2.1 and 44.7 ± 5.8, respectively. A total of 148 patients (88.1%) had poor quality sleep, which was reported only in 37 patients (22%). Excessive daytime sleepiness (80%) and insomnia (76.7%) were most common symptoms. Polysomnographic profile showed poor sleep efficiency (median interquartile range [IQR] 74.8% [17.8%–99.5%]), reduced slow wave sleep (median [IQR] 0% [0%–9.5%]), and reduced rapid eye movement [REM] sleep (median (IQR) 4.9% [0.1%–24.2%]). Sleep disorders in the study were sleep fragmentation (n = 60, 100%), obstructive sleep apnea syndrome (n = 40, 66.7%), central sleep apnea syndrome (n = 6, 10%), and periodic limb movement disorder (n = 52, 86.7%). Two patients had REM sleep behavioral disorder clinically. There was statistically significant positive correlation between staging of disease, sleep latencies, and sleep questionnaire.Conclusion:Sleep is impaired in majority of Parkinsonism patients which needs to be diagnosed early and managed effectively. Patient education and awareness programs in rural areas regarding sleep disorders in Parkinsonism are required for early diagnosis.

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Section: Discussionmentioning

confidence: 99%

Quality of Sleep and Sleep Disorders in Patients with Parkinsonism: A Polysomnography Based Study from Rural South India

Jasti

Mallipeddi

Apparao

et al. 2018

Journal of Neurosciences in Rural Practice

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“…The estimated prevalence of subjective EDS in patients with PD ranges from 15% to 76% (Arnulf et al, 2002;Brodsky, Godbold, Roth, & Olanow, 2003;Buskova et al, 2011;Fabbrini et al, 2002;Factor, McAlarney, Sanchez-Ramos, & Weiner, 1990;Ghorayeb et al, 2007;Gjerstad, Aarsland, & Larsen, 2002;Hobson et al, 2002;Hogl et al, 2003;Kumar, Bhatia, & Behari, 2002;Stevens, Cormella, & Stepanski, 2004;Tan, Lum, Fook-Chong et al, 2002;Tandberg, Larsen, & Karlsen, 1999;Valko et al, 2010;Yong et al, 2011). Subjective EDS in PD has been associated with advanced motor impairment and disease progression, male gender as well as the use of anti-parkinsonian medications (Arnulf, 2005;Buskova et al, 2011;Gjerstad et al, 2002;Martinez-Martin et al, 2012;Paus et al, 2003;Selvaraj & Keshavamurthy, 2016;Tandberg et al, 1999;Valko et al, 2010). Barker, 2013; Breen et al, 2014).…”

Section: Excessive Daytime Sleepinessmentioning

confidence: 99%

An overview of sleep and circadian dysfunction in Parkinson's disease

Mantovani

Smith

Gordon

et al. 2018

Journal of Sleep Research

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Sleep and circadian alterations are amongst the very first symptoms experienced in Parkinson's disease, and sleep alterations are present in the majority of patients with overt clinical manifestation of Parkinson's disease. However, the magnitude of sleep and circadian dysfunction in Parkinson's disease, and its influence on the pathophysiology of Parkinson's disease remains often unclear and a matter of debate. In particular, the confounding influences of dopaminergic therapy on sleep and circadian dysfunction are a major challenge, and need to be more carefully addressed in clinical studies. The scope of this narrative review is to summarise the current knowledge around both sleep and circadian alterations in Parkinson's disease. We provide an overview on the frequency of excessive daytime sleepiness, insomnia, restless legs, obstructive apnea and nocturia in Parkinson's disease, as well as addressing sleep structure, rapid eye movement sleep behaviour disorder and circadian features in Parkinson's disease. Sleep and circadian disorders have been linked to pathological conditions that are often co-morbid in Parkinson's disease, including cognitive decline, memory impairment and neurodegeneration. Therefore, targeting sleep and circadian alterations could be one of the earliest and most promising opportunities to slow disease progression. We hope that this review will contribute to advance the discussion and inform new research efforts to progress our knowledge in this field.

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“…Parkinson's disease (PD) is a progressive neurodegenerative disorder characterised by the cardinal motor symptoms of bradykinesia, rigidity and tremor, and a range of frequent non-motor symptoms such as sleep disturbances, depression and chronic fatigue. Sleep disturbances are estimated to affect between 15 and 96% of patients with PD, constituting a significant source of complaint and affecting quality of life ( Selvaraj and Keshavamurthy, 2016 ; Menza et al, 2010 ). Sleep disturbances in PD are typically divided to insomnia, parasomnias including rapid eye movement (REM) behaviours disorders (RBD), excessive daytime sleepiness (EDS) and drug induced sleep dysfunctions ( Jahan et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Serotonergic dysregulation is linked to sleep problems in Parkinson's disease

Wilson

Giordano

Turkheimer

et al. 2018

NeuroImage: Clinical

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IntroductionSleep disturbances are common non-motor symptoms in Parkinson's disease (PD). Experimental studies suggest involvement of the serotonergic system in the regulation of sleep and arousal. Using [11C]DASB positron emission tomography, a marker of serotonin transporter availability, we investigated whether sleep dysfunction is associated with serotonergic dysfunction in PD.MethodsWe studied 14 PD patients with sleep dysfunction, 14 PD without sleep dysfunction, and 12 healthy controls. Groups were matched for age, disease duration, severity of motor symptoms, daily intake of levodopa equivalent units, body-mass-index, depression and fatigue. [11C]DASB non-displaceable binding potential (BPND) was calculated for regions with a role in the regulation of sleep and arousal.Results[11C]DASB BPND was reduced by 32–49% in PD patients with sleep dysfunction, and 14–25% in PD without sleep dysfunction, compared to healthy controls. PD patients with sleep dysfunction had lower [11C]DASB BPND in caudate (P < 0.01), putamen (P < 0.001), ventral striatum (P < 0.001), thalamus (P < 0.05), hypothalamus (P < 0.001) and raphe nuclei (P < 0.01), compared to PD without sleep dysfunction. Higher severity of sleep symptoms (assessed with Parkinson Disease Sleep Scale) correlated with lower [11C]DASB binding in caudate (r = 0.77; P < 0.001), putamen (r = 0.84; P < 0.001), ventral striatum (r = 0.86; P < 0.001), thalamus (r = 0.79; P < 0.001), hypothalamus (r = 0.90; P < 0.001) and raphe nuclei (r = 0.83; P < 0.001).ConclusionsOur findings demonstrate that sleep dysfunction in PD is associated with reduced serotonergic function in the midbrain raphe, basal ganglia and hypothalamus. Strategies to increase serotonin levels in the brain could be a promising approach to treat sleep dysfunction in PD, and may also have relevance in other neurodegenerative disorders.

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Sleep Dysfunction in Parkinson's Disease

Cited by 22 publications

References 24 publications

Quality of Sleep and Sleep Disorders in Patients with Parkinsonism: A Polysomnography Based Study from Rural South India

Quality of Sleep and Sleep Disorders in Patients with Parkinsonism: A Polysomnography Based Study from Rural South India

An overview of sleep and circadian dysfunction in Parkinson's disease

Serotonergic dysregulation is linked to sleep problems in Parkinson's disease

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