Objective: To document the prevalence of sleep disturbance and excessive daytime sleepiness (EDS) in Taiwanese Parkinson’s disease (PD) patients and to identify the risk factors and correlations among all evaluated parameters.

Background: Sleep problem is one of the major non-motor symptoms which considerably impair the quality of daily life in PD. However, the correlations between disturbed sleep parameters and clinical characteristics of PD are still unclear, and the sleep efficiency impact on cognition is debatable.

Methods: This was a cross-section, questionnaire-based interview study in a tertiary medical center in Taiwan. We collected demography, Unified Parkinson’s disease rating scale (UPDRS), Hoehn and Yahr (H/Y)stage, Pittsburgh sleep quality index (PSQI), Parkinson’s disease sleep scale (PDSS), Epworth sleepiness scale (ESS), 39-Item Parkinson’s disease questionnaire (PDQ-39), mini-mental status examination (MMSE), and Montreal cognitive assessment (MoCA) of PD patients.

Results: 225 PD patients were recruited from January 2011 to December 2015. There were 128 males and 97 females. The onset age was 57.53 ± 9.90, and disease duration 8.18 ± 5.20 years. This study has four major findings: (1) 53.8% of patients were defined as poor sleeper by PSQI > 5. And 26.3% of patients had EDS; (2) The poor sleepers had significant worse scores compared with good sleepers (UPDRS part I and part II p< 0.00; UPDRS part III p= 0.004; MMSE p= 0.039; PDSS p< 0.001; PDQ-39 p<0.001), but there was no differences in MoCA score (p=0.057); (3) EDS had correlation with advanced H&Y stage (p= 0.032) and usage of dopamine agonists (p= 0.02). Nevertheless the levodopa equivalent daily dose (p= 0.67) and hypnotics (p= 0.851) did not play a role in EDS; (4) The most significant predictor of poor sleepers was PDSS questionnaires by using logistic regression analysis (p< 0.001, OR= 0.909). The PDSS score 126 could be a cutoff points to predict if a PD patient a poor sleeper or not (< 126.25, sensitivity 62.8%, specificity 89.4%). Among PDSS, nocturnal PD symptoms and psychosis were the major contributions to poor sleepers.

Conclusions: The prevalence of poor sleepers in Taiwanese PD patients is similar to western countries, but the ratio of EDS is significantly lower than Caucasian PD patients. Sleep disturbance could be an important factor to affect motor symptoms, cognition, and life quality of PD patients even in early stage of the disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-sleep-profiles-and-clinical-features-in-parkinsons-disease/