The Impact of Sleep Quality on Cognitive Functioning in Parkinson's Disease

Stavitsky, Karina; Neargarder, Sandra; Bogdanova, Yelena; McNamara, Patrick; Cronin‐Golomb, Alice

doi:10.1017/s1355617711001482

Cited by 76 publications

(71 citation statements)

References 65 publications

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“…[20, 21] Our results support differing relationships in PD between daytime sleepiness and PD cognitive impairment versus night-time sleep disturbances and cognitive impairment, thereby extending our prior report[4] to a larger, broader PD population. This dichotomy indicates that greater daytime sleepiness in PD cannot be solely a consequence of poor nighttime sleep.…”

Section: Discussionsupporting

confidence: 83%

Relationships among cognitive impairment, sleep, and fatigue in Parkinson's disease using the MDS-UPDRS

Goldman¹,

Stebbins²,

Leung³

et al. 2014

Parkinsonism & Related Disorders

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Background Non-motor complications of Parkinson’s disease (PD), specifically cognitive impairment, sleep disturbances, and fatigue, are recognized as important contributors to poor patient outcomes and quality of life. How sleep problems and fatigue interrelate and impact cognitive function, however, has not systematically been investigated across the stages of PD. The aim of our study was to investigate the relationships among cognitive impairment, night-time sleep problems, daytime sleepiness, and fatigue across all severities of PD. Methods We examined these non-motor problems using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) in a study of 1319 PD patients drawn from three large cohort studies: the Parkinson’s Progressive Markers Initiative, the Rush University PD Cognitive-Behavioral-Imaging study, and the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale Clinimetric testing program study, which spanned the gamut of disease, from early to advanced PD. Generalized linear mixed models with logit linking functions and covariates including study cohort, age, PD duration, and presence/absence of PD medications were used to examine relationships between these three non-motor symptoms and cognitive impairment. Results Of these three frequent, and often inter-twined, non-motor complications, greater daytime sleepiness and fatigue were associated with worse cognitive impairment across the full spectrum of PD (F[16,1158]=2.40 and F[16,1158]=3.45 respectively, p’s<0.0005), but an association with night-time sleep was not detected (p=0.83). Conclusions Given this association of daytime sleepiness and fatigue with cognitive impairment, clinical monitoring for these problems should be considered across all points in the PD spectrum, from early to more advanced disease.

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Section: Discussionsupporting

confidence: 83%

Relationships among cognitive impairment, sleep, and fatigue in Parkinson's disease using the MDS-UPDRS

Goldman¹,

Stebbins²,

Leung³

et al. 2014

Parkinsonism & Related Disorders

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“…One other study reported that ESS scores did not correlate significantly with attention/executive function, memory, and psychomotor function, but the primary emphasis of this study was on nighttime function with actigraphy in non-demented PD patients; furthermore, no details of the ESS scores or their relationships were provided. [25] Several key methodological differences between these studies and ours could account for differences in results, including differences in sleep and cognitive measures (i.e., scales used, comparison of cognitive domains or individual neuropsychological tests) and PD patient population (i.e., treated patients, inclusion of demented patients). Nonetheless, sleep-wake disturbances may relate differently to specific elements of PD cognition, and further study of these relationships may advance our understanding of their underlying neural substrates and development of therapeutic interventions for both sleep and cognition.…”

Section: Discussionmentioning

confidence: 85%

Dissociations among daytime sleepiness, nighttime sleep, and cognitive status in Parkinson's disease

Goldman

Ghode

Ouyang

et al. 2013

Parkinsonism & Related Disorders

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Background Daytime and nighttime sleep disturbances and cognitive impairment occur frequently in Parkinson’s disease (PD), but little is known about the interdependence of these non-motor complications. Thus, we examined the relationships among excessive daytime sleepiness, nighttime sleep quality and cognitive impairment in PD, including severity and specific cognitive deficits. Methods Ninety-three PD patients underwent clinical and neuropsychological evaluations including the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Patients were classified as having normal cognition (PD-NC), mild cognitive impairment (PD-MCI), or dementia (PDD) using recently proposed Movement Disorder Society PD-MCI and PDD criteria. Relationships between the sleep and cognitive measures and PD cognitive groups were examined. Results The PD cohort included PD-NC (n=28), PD-MCI (n=40), and PDD (n=25) patients. ESS scores, as a measure of daytime sleepiness, were significantly worse (p=0.005) in cognitively impaired PD patients, particularly PDD patients. ESS scores correlated significantly with Mini-Mental State Examination scores and also with cognitive domain scores for attention/working memory, executive function, memory, and visuospatial function. In contrast, PSQI scores, as a measure of nighttime sleep quality, neither differed among cognitive groups nor correlated with any cognitive measures. Conclusions Daytime sleepiness in PD, but not nighttime sleep problems, is associated with cognitive impairment in PD, especially in the setting of dementia, and attention/working memory, executive function, memory, and visuospatial deficits. The presence of nighttime sleep problems is pervasive across the PD cognitive spectrum, from normal cognition to dementia, and is not independently associated with cognitive impairment or deficits in cognitive domains.

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“…--Lower scores on measures of attention/executive function[115] and working memory[81] (associated with actigraphically-measured sleep measures)…”

Section: Figmentioning

confidence: 99%

A systematic review of the literature on disorders of sleep and wakefulness in Parkinson's disease from 2005 to 2015

Chahine

Amara

Videnović

2017

Sleep Medicine Reviews

273

249

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Sleep disorders are among the most common non-motor manifestations in Parkinson’s disease (PD) and have a significant negative impact on quality of life. While sleep disorders in PD share most characteristics with those that occur in the general population, there are several considerations specific to this patient population regarding diagnosis, management, and implications. The available research on these disorders is expanding rapidly, but many questions remain unanswered. We thus conducted a systematic review of the literature published from 2005-2015 on the following disorders of sleep and wakefulness in PD: REM sleep behavior disorder, insomnia, nocturia, restless legs syndrome and periodic limb movements, sleep disordered breathing, excessive daytime sleepiness, and circadian rhythm disorders. We discuss the epidemiology, etiology, clinical implications, associated features, evaluation measures, and management of these disorders. The influence on sleep of medications used in the treatment of motor and non-motor symptoms of PD is detailed. Additionally, we suggest areas in need of further research.

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The Impact of Sleep Quality on Cognitive Functioning in Parkinson's Disease

Cited by 76 publications

References 65 publications

Relationships among cognitive impairment, sleep, and fatigue in Parkinson's disease using the MDS-UPDRS

Relationships among cognitive impairment, sleep, and fatigue in Parkinson's disease using the MDS-UPDRS

Dissociations among daytime sleepiness, nighttime sleep, and cognitive status in Parkinson's disease

A systematic review of the literature on disorders of sleep and wakefulness in Parkinson's disease from 2005 to 2015

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