Objective: The objective of the study was to investigate the sleep quality and other sleep disorders among essential tremor (ET) patients and also to explore the related factors of ET with poor quality of sleep.

Background: Several studies have documented the non-motor symptoms in ET patients [¹]. Early postmortem study had demonstrated the presence of Lewy bodies pathology in the brainstem may raise the possibility of developing sleep disturbances in ET [¹]. Sleep quality and its related factors among ET patients remain controversial.

Method: We enrolled 162 ET patients and 155 age, sex matched healthy controls (HC). Movement disorder specialists collected the demographic information and clinical characteristics Further, Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), other sleep disturbances were evaluated via Epworth Sleepiness Score (ESS) .etc respectively. Moreover, related non-motor symptoms including cognitive function and affective symptoms were evaluated separately.  ET patients with PSQI scored no less than 6 were considered to have a poor quality of sleep (ET-sle), the others were considered normal (ET-nor). ANOVA and the Chi-square test were used for comparison between 3 groups. Finally, we used binary logistic analysis to explore the determinants of poor quality of sleep in ET.

Results: Compared with ET-nor patients, ET-sle patients were older at age, age of onset(Table 1).  ET-sle patients were more likely presenting with rest or intention tremor also with worse tremor severity. Also, both subgroups of ET patients scored higher in PSQI, RBD, IRLSSG, and EDS compared with HC (P<0.05).  ET-sle patients also showed lower cognitive and affective symptoms rating scores (P<0.05). Further Binary Logistic analysis showed factors associated with poor quality of sleep were the presence of head tremor and higher HAMD scores(Table 3).

Conclusion: ET patients presented impaired quality of sleep, RBD, RLS, and ESS symptoms compared with healthy controls. ET patients with poor quality of sleep were more likely accompanied with neurological soft signs and worse tremor severity. ET with head tremor patients and those with more obvious depression symptoms patients were related to poor quality of sleep. The presence of impaired quality of sleep in ET patients may suggest more advanced neuropathological changes along with the disease progression.

References: 1. Louis ED. Non-motor symptoms in essential tremor: A review of the current data and state of the field. Parkinsonism Relat Disord 2016;22 Suppl 1:S115-118. 2. Jimenez-Jimenez FJ, Alonso-Navarro H, Garcia-Martin E, Agundez JAG. Sleep disorders in essential tremor: systematic review and meta-analysis. Sleep 2020;43(9).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-sleep-quality-and-its-related-factors-of-essential-tremor-patients/