Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson’s Disease

Santos‐García, Diego; Castro, Ester Suárez; Fonticoba, Teresa de Deus; Panceiras, Maria J. Feal; Enríquez, José Guillermo Muñoz; González, Jose Manuel Paz; Bartolomé, Carlos Cores; Planellás, Lluís; Caldentey, Juan García; Caballol, Núria; Legarda, I; López, Iria Cabo; Manzanares, Lydia López; Rivera, María A. Ávila; Catalán, María José; Nogueira, Víctor; Borrué, Carmen; Saúco, María Álvarez; Vela, Lydia; Cubo, Esther; Castrillo, Juan Carlos Martínez; Alonso, Pilar Sánchez; Losada, Maria G. Alonso; López-Ariztegui, N; Gastón, M I; Kulisevsky, Jaime; Pagonabarraga, Javier; Seijo, Manuel; Martínez, Javier Rúiz; Valero, Caridad; Kurtis, Mónica; Ardura, Jessica González; Prieto, Cristina; Mir, Pablo; Martínez-Castrillo, Juan Carlos

doi:10.1177/0891988720964250

Cited by 17 publications

(18 citation statements)

References 34 publications

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“…Another important factor is mood. Like in other studies, the mean score of BDI didn’t change over time 18 , 22 , suggesting that depression-type frequency does not appear to change over time in PD 45 . Cross-sectional studies have reported the clear contribution of depression or a worse mood to a poorer QoL in PD patients 3 , 12 , 13 .…”

Section: Discussionsupporting

confidence: 66%

Predictors of clinically significant quality of life impairment in Parkinson’s disease

Santos‐García

Fonticoba

Cores

et al. 2021

npj Parkinsons Dis.

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Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p = 0.665; R2 = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.

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Section: Discussionsupporting

confidence: 66%

Predictors of clinically significant quality of life impairment in Parkinson’s disease

Santos‐García

Fonticoba

Cores

et al. 2021

npj Parkinsons Dis.

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“…With regard to sleep problems, there is a progressive increase in the frequency of sleep disturbances in PD, with the number of subjects reporting multiple sleep disturbances increasing over time [ 48 ]. Recently, we observed in the baseline analysis of the COPPADIS cohort that NMS burden was associated with sleep problems after adjustment for age, gender, disease duration, LEDD, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments [ 49 ]. Here, after a 2-year follow-up we observed that changes in sleep predict changes in the global NMS burden.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Global Non-Motor Symptoms Burden Progression in Parkinson’s Disease. Results from the COPPADIS Cohort at 2-Year Follow-Up

Santos‐García

Deus

Bartolomé

et al. 2021

JPM

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Background and Objective: Non-motor symptoms (NMS) progress in different ways between Parkinson’s disease (PD) patients. The aim of the present study was to (1) analyze the change in global NMS burden in a PD cohort after a 2-year follow-up, (2) to compare the changes with a control group, and (3) to identify predictors of global NMS burden progression in the PD group. Material and Methods: PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017, were followed-up with after 2 years. The Non-Motor Symptoms Scale (NMSS) was administered at baseline (V0) and at 24 months ± 1 month (V2). Linear regression models were used for determining predictive factors of global NMS burden progression (NMSS total score change from V0 to V2 as dependent variable). Results: After the 2-year follow-up, the mean NMS burden (NMSS total score) significantly increased in PD patients by 18.8% (from 45.08 ± 37.62 to 53.55 ± 42.28; p < 0.0001; N = 501; 60.2% males, mean age 62.59 ± 8.91) compared to no change observed in controls (from 14.74 ± 18.72 to 14.65 ± 21.82; p = 0.428; N = 122; 49.5% males, mean age 60.99 ± 8.32) (p < 0.0001). NMSS total score at baseline (β = −0.52), change from V0 to V2 in PDSS (Parkinson’s Disease Sleep Scale) (β = −0.34), and change from V0 to V2 in NPI (Neuropsychiatric Inventory) (β = 0.25) provided the highest contributions to the model (adjusted R-squared 0.41; Durbin-Watson test = 1.865). Conclusions: Global NMS burden demonstrates short-term progression in PD patients but not in controls and identifies worsening sleep problems and neuropsychiatric symptoms as significant independent predictors of this NMS progression.

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“…The relationship between sleep disorders and mood disorders has been widely confirmed in different populations beyond PD patients, 4–6 , 25 , 33 and these comorbidities have mutual influence. 9 In drug-naïve patients with PD, poor sleepers were more likely to experience anxiety and depression, and we found this phenomenon is more substantial in female patients, which was consistent with Mahale’s finding.…”

Section: Discussionmentioning

confidence: 95%

“…In levodopa-treated patients with PD, sleep disruption is related with greater NMS burden and poorer life quality. 4 More central PD-related pain, 5 higher levodopa intake, 2 longer disease duration, 6 poorer cognition, 7 and more fatigue 8 are associated with worse sleep quality. Sleep disturbances and mood disorders often appear as comorbidities.…”

Section: Introductionmentioning

confidence: 99%

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

Zhong

Jiang

Zhu

et al. 2021

NDT

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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.

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Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson’s Disease

Cited by 17 publications

References 34 publications

Predictors of clinically significant quality of life impairment in Parkinson’s disease

Predictors of clinically significant quality of life impairment in Parkinson’s disease

Predictors of Global Non-Motor Symptoms Burden Progression in Parkinson’s Disease. Results from the COPPADIS Cohort at 2-Year Follow-Up

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

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