Objective: Assessment of the incidence of insomnia, its association with motor, neuropsychiatric disorders, clarifying the impact on the quality of life of patients with PD at different stages of the disease.

Background: Sleep problems may be an early sign of Parkinson’s disease, even before motor symptoms have begun. Some of the common sleep problems for Parkinson’s patients include: insomnia, excessive daytime sleepiness, nightmares sleep attacks (a sudden involuntary episode of sleep), REM sleep behavior disorder (acting out dreams during sleep), periodic leg movement disorder (PLMD), restless legs syndrome (RLS), sleep apnea, nocturia (frequent nighttime urination).

Methods: The study involved 160 patients (90 men and 70 women) were diagnosed with PD without dementia, the average age was 61.36 ± 0.6 years, the stage was 2.30 ± 0.5, and the PD duration was 5.8 ± 3.8 years. Hoehn-Yahr stage evaluation, the unified PD assessment scale, Beck depression questionnaires, Spielberger anxiety, Parkinson’s Disease Sleep Scale (PDSS), Euphoria sleepiness – Excessive Sleep Scale (ESS), a quality of life questionnaire under the PD – Parkinson’s Disease Quality of Life (PDQ-39) were used.

Results: Sleep disturbances were noted in 36% of patients, night awakenings with sleep fragmentation in 82%, early awakenings in 41% of patients. A greater frequency of disturbances of sleep, night awakenings, unpleasant dreams were noted in women. There was a tendency to intensify insomnia as the severity increased and the duration of PD increased. Patients with the onset of insomnia in the “premotor” stage of PD were statistically significant (p <0.05) differed from patients in other groups more low self-esteem of the quality of sleep, the severity of sleep disturbances, the greater frequency of nocturnal awakenings. Patients with early awakenings statistically significant (p <0.05) were characterized by greater severity of sleep disturbances, frequency of nocturnal awakenings, lower self-esteem of sleep quality, severity of depression, personal anxiety, nocturia. A statistically significant correlation between integrative assessments of sleep disorders and quality of life in the 1-3 stages of BP is shown (p <0.05).

Conclusions: Sleep disorders in patients with PD are heterogeneous – partly due to the age factor, motor and non-motor (emotional, sensory, neurourological) disorders. Based on the multifactority of insomnia in PD, effective therapy of patients with sle.ep disorders should be individualized taking into account the nature of motor disorders, dissominia symptoms, concomitant emotional disorders

References: 1. Barone P, Amboni M, Vitale C. Treatment of nocturnal disturbances and excessive daytime sleepiness in Parkinson’s disease. Neurology. 2004;26:S35–8. 2. Johns MW. A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep. 1991;14:540–5.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-evaluation-of-insomnia-in-parkinsons-disease-and-its-effect-on-the-quality-of-life-of-patients/