Objective: To determine the association between excessive daytime sleepiness (EDS) and activities of daily living (ADL) in Parkinson’s disease (PD) patients.

Background: EDS is a common and underestimated symptom in PD which negatively impacts the quality of life (QoL) of PD patients. Parkinson’s Kinetigraph (PKG) has been shown to be a reliable objective measure of symptoms in PD patients. Specifically, the proportion of time immobile (PTI) score has shown to be a strong indicator of EDS in clinical practice.

Method: This is a descriptive, retrospective study conducted at one movement disorder center. We reviewed clinical records of PD patients seen in our unit in a two-year period (2015-2017). A Parkinson’s KinetiGraph (PKG Global Kinetics CorporationTM, Australia) was provided to these patients at that time as part of the routine care. A structured interview including demographics and clinical information was performed. PDQ-39 was self-administered. We used the ADL domain of the PDQ-39 to assess ADL. The Proportion of Time Immobile (PTI) obtained from PKG was used to assess EDS. The correlation between PTI and ADL was calculated using Spearman correlation coefficient.

Results: This analysis included 80 patients (51.2%males, 69.9 ± 10.4 years old, 7.7± 6.5 years of disease duration, 845.42 ± 462.9 mg levodopa equivalent dose). PTI scores (PTI median 9  [4.2 – 16.9 ]) showed a significant positive correlation with ADL scores (rho=0.338, p=0.005). There was no positive correlation with PDQ-39 global score.

Conclusion: PD patients with daytime sleepiness have worse performance of ADL, which is an indicator of QoL. Recognising and addressing daytime sleepiness in the routine practice might improve the QoL of PD patients.

References: [1] K.Kotschet, W. Johnson, S. McGregor, J. Kettlewell, A. Kyoong, D.M. O’Driscoll, A.R. Turton, R.I. Griffiths, M.K. Horne. Daytime sleep in Parkinson’s disease measured by episodes of immobility. Parkinsonism and Relatred Disorders 20 (2004)579-583. [2] P. Odin, KR. Chaudhuri, J. Volkmann, A Antonini et al. Viewpoint and practical recommendations from a movement disorder specialist panel on objective measurement in the clinical management of Parkinson’s disease. NPJ Parkinsons Dis May 10 (2018) 4-14. [3] P. Bargiotas, L. Lachenmayer, D. Schreier, J. Maths, C. Bassetti. Sleepiness and Sleepiness Perception in Patients with Parkinson’s disease: a clinical and electrophysiological study. Sleep 2019 doi: 10.1093/sleep/zsz004

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MDS Abstracts - https://www.mdsabstracts.org/abstract/daytime-sleepiness-in-parkinsons-disease-an-indicator-of-impaired-activities-of-daily-living/