Objective: To examine the frequency and risk factors of excessive daytime sleepiness (EDS) in patients with PD and to determine relationships between EDS and another symptoms of PD.

Background: EDS is a frequent symptom in PD and seems to be multifactorial by nature. The risk factors of EDS and associations with another symptoms are not enough investigated.

Methods: PD patients [N=32 (18M); 64,7±6,3 years old; 4,4±3,15 (0.3-12) years motor disease duration, HY range 1-3, and mean MoCA score 25.5±1.9 (22-29)] underwent clinical evaluation including the Epworth Sleepiness Scale (ESS) and the Parkinson’s disease sleep scale – 2 (PDSS-2), the Hoehn and Yahr scale and the MDS-Unified Parkinson’s disease rating scale (MDS-UPDRS), the Parkinson’s disease questionnaire (PDQ-39), Schwab and England Activities of Daily Living Rating (SE-ADL) and Hospital anxiety and depression scale (HADS). EDS was diagnosed according to the ESS, cutoff score above 10 was applied. All patients with EDS underwent one-night video-polysomnography study and the multiple sleep latency test (MSLT).

Results: 50% of patients had EDS. Baseline characteristics were similar between patients with and without EDS. Patients with EDS had higher PDSS-2 score (p=0,002), more prominent autonomic dysfunction and cognitive impairment (p=0,01), worse quality of life and lower daytime activity (p<0,01). EDS was associated with higher levodopa equivalent dose (LED) (633,8 versus 280,0; p=0,002), longer duration of therapy and part I, II and total MDS-UPDRS higher score (p=0,01). The mean time of sleep was 6,7±1,1 hours, index of sleep quality was 76,2±12,7%. Patients had reduced amount of deep wave sleep and a lot of awakenings. 31% had obstructive sleep apnea (OSA), but mean oxygen saturation was 93,8±1,3. The mean sleep latency (SL) was 7,5±4,3 min. Correlation between the apnea-hypopnea index (AHI) and mean SL was not found.

Conclusions: E

EDS occurs in 50% of patients with PD and associated with higher MDS-UPDRS score, more frequent autonomic dysfunction, cognitive impairment, higher LED, lower quality of life and daytime activity. Patients with EDS have fragmented sleep, but sleep duration is sufficient. 31% of patients had AHI>5, that indicates a wide frequency of OSA in PD and a potential role in genesis of EDS. However, SL values in such patients and absence of oxygen desaturation profile of OSA suggest the “abortive” OSA.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/excessive-daytime-sleepiness-in-parkinsons-disease-risk-factors-and-clinical-associations/