Session Information
Date: Monday, October 8, 2018
Session Title: Parkinson's Disease: Non-Motor Symptoms
Session Time: 1:15pm-2:45pm
Location: Hall 3FG
Objective: To investigate the efficacy of levodopa/carbidopa/entacapone (Stalevo®) at bedtime on sleep disturbance in patients with Parkinson’s disease (PD) who have motor fluctuation.
Background: Sleep disturbances, such as sleep onset insomnia, sleep fragmentation, rapid eye movement sleep behavior disorder (RBD), and excessive daytime sleepiness is the major disabling non-motor symptoms of PD. Clinical motor and nonmotor symptoms associated with sleep disturbance are still unclear and no choice of treatment has been demonstrated.
Methods: We studied 54 PD patients with motor fluctuation and sleep disturbance that was defined as Parkinson’s Disease Sleep Scale (PDSS) ≤120 or Epworth Sleepiness Scale (ESS) ≥8. In this open-label study, PD patients were prescribed with additional bedtime Stalevo®. We assessed motor and nonmotor scales, including PDSS, ESS, RBD Sleep Questionnaire (RBDSQ), United Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Quality of Life Questionaire-39 (PDQ-39), and Nonmotor Symptom assessment scale (NMSS). Sleep improvement by bedtime Stalevo® was defined as more than 15% improvement in PDSS scores in 3 months.
Results: The assessment at 3 months after the start of bedtime Stalevo® was completed in 34 PD patients (63%). Sleep improvement by bedtime Stalevo® was observed in 18 (53% of 34) patients but there was no improvement in 16 (47% of 34). At baseline, PDSS score was significantly lower in sleep improvement group compared with no improvement group (P = 0.025) [table1]. At 3 months, NMSS score as well as the PDSS score were much improved significantly in sleep improvement group compared with no improvement group [table2]. At 3 months, ESS, RBDSQ, total UPDRS, and NMSS scores as well as the PDSS score were significantly improved in sleep improvement group compared to the scores at baseline [table3], suggesting the overall improvement of sleep quality, nonmotor and motor symptoms in this group.
Conclusions: Our results suggest that bedtime Stalevo® may have beneficial effect on sleep disturbance of PD patients with motor fluctuation. Further studies are needed to identify the determining factors of efficacy of bedtime Stalevo® in those PD patients.
To cite this abstract in AMA style:
KW. Park, HS. Ryu, MS. Kim, NR. Choi, SJ. Chung. Effect of bedtime levodopa/carpidopa/entacapone (Stalevo®) on sleep disturbance in patients with Parkinson’s disease with motor fluctuation [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/effect-of-bedtime-levodopa-carpidopa-entacapone-stalevo-on-sleep-disturbance-in-patients-with-parkinsons-disease-with-motor-fluctuation/. Accessed September 7, 2024.« Back to 2018 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-bedtime-levodopa-carpidopa-entacapone-stalevo-on-sleep-disturbance-in-patients-with-parkinsons-disease-with-motor-fluctuation/