Objective: To evaluate the effect of the Zeez Sleep Pebble© on sleep disturbance in Parkinson’s disease.

Background: Sleep disturbance is common in Parkinson’s disease (PD) [1,2]. Medication options exist, but patients are often reluctant to add to their medication burden. The Zeez Sleep Pebble© (www.zeez.org.uk) is designed to improve sleep quality. Placed under the pillow, it emits a weak electrical signal designed to match brain activity frequency during sleep. Following a patient self-report of sleep improvement with the device, we were interested to evaluate it within our service.

Method: Patients attending Parkinson’s clinics for routine review were offered the Zeez Sleep Pebble© if they reported sleep disturbance. Devices were provided by the manufacturer. As part of routine sleep assessment, patients were asked to complete the Parkinson’s Disease Sleep Scale (PDSS-2) before and after a mean of 12 weeks of using the Zeez Sleep Pebble©. The pebble was given to a further 9 patients for usability feedback.

Results: 13 patients completed PDSS-2 questionnaires. Responders were identified as those with an improvement of at least 10% in PDSS-2 score. 46.2% (n=6) were responders, with a mean improvement of 36.4% (PDSS-2 before 30.5 (SD 7.3); after 20.2 (SD 10.0) p=0.005). Non-responders had a lower PDSS-2 score at baseline (mean 18.1 (SD 5.9), with no significant change following device use. The mean age of participants was 73.5 (56-84) years, with no difference between responders and non-responders. Within the responders, there were significant improvements in the PDSS-2 motor (p=0.009), PD (p=0.007) and sleep (p=0.03) subdomains. Of the 6 responders, 2 reported a subjective improvement in sleep quality. Two of the non-responders also reported subjective improvement, but admitted to only intermittent use of the device. 15 patients provided feedback on device usability; most (86.7%) found it easy to use. 26.7% (n=4) said that improvements could be made to the on/off button and 33.3% (n=5) would have preferred a wristwatch style device.

Conclusion: In this evaluation, almost 50% of patients experienced significant improvement in PDSS-2 scores, with responders having higher baseline PDSS-2 scores, in the range indicative of clinically significant sleep disturbance[3]. Participants generally found the device easy to use. The device offers a potential alternative to medication for sleep disturbance in PD, and merits further evaluation.

References: 1. Chaudhuri K.R, Pal S, DiMarco A et al. The Parkinson’s disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson’s disease. Journal of Neurology, Neurosurgery and Psychiatry. 2002. 73: 629-635. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1757333/pdf/v073p00629.pdf. [Accessed 9th February 2019]. 2. Menza M, De Fronzo Dobkin R, Marin H et al. Sleep Disturbances in Parkinson’s Disease. Movement Disorders. 2010. 25 (Supple 1): S117-S122. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840057/ [Accessed 9th February 2019]. 3. Muntean ML, Benes H, Sixel-Döring F, Chaudhuri KR, Suzuki K, Hirata K, Zimmermann J, Trenkwalder C. Clinically relevant cut-off values for the Parkinson’s Disease Sleep Scale-2 (PDSS-2): a validation study. Sleep Med. 2016 Aug;24:87-92. doi: 10.1016/j.sleep.2016.06.026. Epub 2016 Aug 24

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluation-of-the-zeez-sleep-pebble-for-sleep-disturbance-in-parkinsons-disease/