Clinical Features and Correlates of Poor Nighttime Sleepiness in Patients with Parkinson's Disease.

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ObjectiveThe present study investigated the clinical features and correlates of poor nighttime sleepiness (PNS) in patients with Parkinson's disease (PD).MethodsOne hundred ten patients with PD (divided into PD-PNS group and PD-nPNS group) and forty-seven controls (nPD-PNS group) were enrolled in this study. Demographic information was collected. Patients were assessed according to the unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr (H&Y) stage scale. Patients were also evaluated according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), rapid eye movement sleep behavior disorder screening questionnaire (RBD-SQ), restless leg syndrome (RLS) diagnosis, Hamilton's depression scale (HAMD), and Hamilton's anxiety scale (HAMA).ResultsThe prevalence of PNS was 55.45% (61/110) in patients with PD. The PD-PNS group tended to have a longer duration of disease, higher UPDRS-I and UPDRS-III scores, a higher percentage of RLS patients, and higher HAMA and HAMD scores than those of the PD-nPNS group. The PD-PNS group tended to have a higher percentage of RBD and RLS patients and higher HAMA and HAMD scores than those of the nPD-PNS group. Analysis of the PSQI components and PSQI impact factors showed that the PD-PNS group had worse subjective sleep quality (χ 2 = -2.267, P = 0.023), shorter sleep latency (χ 2 = -2.262, P = 0.024), fewer sleep medications (χ 2 = -4.170, P ≤ 0.001), worse daytime functioning (χ 2 = -2.347, P = 0.019), and an even higher prevalence of increased nocturia (χ 2 = 4.447, P = 0.035), nightmares (χ 2 = 7.887, P = 0.005), and pain (χ 2 = 9.604, P = 0.002) than those of the nPD-PNS group. Analysis also indicated that the PSQI global score positively correlated with BMI (r = 0.216, P r = 0.223, P r = 0.501, P r = 0.425, P r = -0.296, P r = 0.227, P r = 0.254, P r = 0.329, P r = 0.466, P P ≤ 0.001, P ≤ 0.001, P = 0.049, P ≤ 0.001, respectively).ConclusionsOur data showed that PNS was common in patients with PD. H&Y stage, UPDRS-III, HAMD, and RLS were positively associated with PNS. Attention to the management of motor symptoms, RLS, and depression may be beneficial to nighttime sleep quality in patients with PD.

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