Objective: To assess the quality of sleep, incidence of RBD and excessive daytime sleepiness in Young Onset Parkinson’s disease patients.

Background: Sleep disorders are one of the most frequently encountered non motor symptom (NMS) in Parkinson’s disease. The prevalence of sleep disorders can be as high as 40% as reported in previous studies. It has been shown that prevalence of RBD is lower in YOPD as compared to older onset PD. There is lack of data on the quality of sleep, presence of RBD and excessive day time sleepiness in a large cohort of YOPD patients.

Method: We prospectively recruited 115 patients of YOPD (defined as age at onset<45 years) at a tertiary care centre in South India. All patients satisfied the UKPD brain bank criteria for diagnosis of PD. Assessment of sleep quality was done using standardized questionnaires-Epworth Sleepiness Scale,RBDSQ and Pittsburgh quality of sleep index.

Results: The mean age at onset was 37.42±6.3 years.Male to female ratio was 2.19:1. The mean duration of illness was 6.6±5.31 years. The mean UPDRS (OFF) was 35.1±5.3. Mean UPDRS(ON) was 14.23±9.27. Medication profile included levodopa in 72.1%, pramipexole in 44.3%, Ropinirole in 14.8%, Amantadine in 26%. Excessive daytime sleepiness(score of more than 10 on ESS) was seen in 17.84%patients. Presence of RBD as judged by RBDSQ score more than 6 was present in 17.84% patients. Poor sleep quality (defined as PSQI score>5) was found in 60% patients. Age at onset did not correlate with presence of EDS (P=0.54),RBD(P=0.4) or poor sleep quality(P=0.53).Patients having RBD were likely to be poor sleepers than those without RBD (P=0.0045). However,poor sleep at night did not correlate with presence of EDS(P=0.14).

Conclusion: This study has shown that poor sleep quality has a high prevalence in YOPD. Presence of RBD affects the sleep quality adversely. The lack of association between poor sleep quality at night and excessive daytime sleepiness may be due to other factors like use of medication like DA agonists. Relationship of sleep with other nonmotor symptoms and its impact on quality of life will be further explored in the study.

References: 1)

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-disturbances-in-young-onset-parkinsons-disease/