Objective: To explore sleep disturbances in Parkinson’s disease (PD) patients and to investigate their associations with fatigue, mood, cognition and function, and their contribution to quality of life (QoL).

Background: Parkinson’s Disease (PD) is neurodegenerative disorder which commonly presents with both motor and non-motor symptoms. The non-motor symptoms affect Quality of Life (QoL) more than the motor symptoms. Sleep disturbance in Parkinson’s disease is often undetected due to inadequate history taking and poor self-reporting. To date, there are very few studies on sleep in PD.

Methods: This prospective cross-sectional study included consecutive idiopathic PD patients seen at the PD Assessment Clinic at the Singapore General Hospital from June 2015 to Feb 2017, for annual evaluation by trained staff. Each patient was evaluated using the PD sleep scale (PDSS-2), Unified PD disease severity rating scale (UPDRS-activities of daily living (ADL) and motor symptoms), PDQ-8 QoL, Montreal Cognitive Assessment (MoCA) scale, fatigue and mood (PD non-motor symptom scale). Descriptive statistics for sleep problems were reported. Associations between sleep and other continuous variables were analysed using bivariate correlations. Hierarchical multiple regression was used to determine the contribution of sleep to QoL, while controlling for the effects of age, UPDRS-ADL and motor scores. Significance was set at p< 0.05.

Results: 96 patients (69% male, mean age 67.5years). 84.4% reported bad night-sleep quality due to waking up to pass urine (79%), remaining asleep (43%) and distressing dreams (37%). Higher levels of sleep disturbances were significantly associated with higher levels of fatigue (rs=0.4), and poorer mood (rs=0.3), UPDRS-ADL (rs=0.5) and QoL (rs=0.4), but not with cognition or PD-motor symptoms. The final regression model explained 51.7% of the variance in QoL (F(6,79)=14.08, p< 0.001) with three statistically significant factors: UPDRS-ADL, and two sleep-related factors: night motor and night PD symptoms. Sleep-related factors accounted for 13.3% of the variance in QoL (p< 0.001).

Conclusions: Sleep disturbances are common in early to moderate stage-PD patients, and were associated with lower levels of QoL, beyond the effects of age and disease severity. This study highlights the importance of evaluating and addressing sleep disturbances in these patients, which is often overlooked in current clinical settings.

References: The abstract was presented at SGH 22nd Annual Scientific Meeting on 7th April 2017 & NNI-Neuroscience ACP Research Day on 13th April 2017 in Singapore. Poster display at XXII World Congress on Parkinson’s Disease and Related Disorders at Ho Chi Minh City, Vietnam (12-15 November 2017).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-disturbances-and-quality-of-life-in-people-with-parkinsons-disease/