Objective: To test whether subjective sleep perception is associated with objective sleep parameters by comparing video-polysomnographic (vPSG) data from Parkinson’s disease (PD) patients with scorings < and > 18 on the Parkinson’s disease Sleep Scale in its 2nd version (PDSS-2).

Background: The PDSS-2 assesses sleep problems in patients with PD. Recently we estimated a cut-off score of 18 as a predictor of a sleep disturbance severe enough to warrant further diagnostic work-up including vPSG (1).

Methods: Patients with clinically confirmed early PD (DeNoPa cohort at two year follow-up; disease duration 2 yrs.) completed the PDSS-2 and the Epworth Sleepiness Scale (ESS), and underwent vPSG. Demographic and questionnaire data as well as vPSG sleep parameters of those patients with PDSS-2 scoring < 18 (A) were compared to those with PDSS-2 scorings > 18 (B).

Results: 112 patients, all with dopaminergic treatment, had complete questionnaire and vPSG data sets and could be included in the study. PDSS-2 scorings were below < 18 in 66/112 (59%) (A), and > 18 in 46/112 (41%) (B) PD patients (p=0.01). Those with PDSS-2 > 18 were older (B: 67.7+9.1 yrs. vs A: 64+9.9 yrs; p=0.04) and showed higher ESS scorings (B: 9.7+4.5 vs A: 7.8+4.3; p=0.033). There was no difference in gender distribution. VPSG identified sleep disordered breathing in 15/66 (23%) patients from group A and 13/46 (28%) patients from group B (n.s.). REM sleep behavior disorder affected 28/66 (42%) patients from group A and 21/46 (46%) patients from group B (n.s.). Sleep latency, sleep efficiency, sleep stage distribution, periodic leg movement indices and awakenings did not differ.

Conclusions: In early PD, subjective severe sleep disturbances with PDSS-2 scores > 18 were less frequent than moderate to light sleep problems. PDSS-2 scorings > 18 were associated with older age and more daytime sleepiness (ESS), but not with sleep disordered breathing or specific motor sleep disorders such as REM sleep behavior disorder or periodic leg movements. Sleep parameters as measured with vPSG do not converge with subjective PDSS-2 ratings in early PD. Reference 1) Muntean ML, Benes H, Sixel-Döring F, Zimmermann J, Trenkwalder C. Validation of cut-off values for the Parkinson’s disease Sleep Scale-2 (PDSS-2) (submitted).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/do-subjective-ratings-of-the-parkinsons-disease-sleep-scale-2-converge-with-results-from-polysomnography-in-early-parkinsons-disease-a-report-from-the-denopa-cohort/