Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Nighttime sleep disorders in patients with daytime sleepiness in Parkinson s disease

https://doi.org/10.14412/2074-2711-2018-4-23-29

Full Text:

Abstract

Daytime sleepiness is one of the clinically significant non-motor manifestations of Parkinson's disease (PD). One of its insufficiently studied aspects is a relationship between daytime sleepiness and nighttime sleep disorders.

Objective: to clarify the clinical characteristics of PD in patients with different types of daytime sleepiness and to estimate of the ratio of daytime sleepiness to clinical and polysomnographic characteristics of nighttime sleep in patients with advanced stages of PD.

Patients and methods. The investigation included 110 patients (56 men and 54 women) (mean age, 63.78+0.6 years) with PD (Hoehn and Yahr stage 2.6+0.2; disease duration, 6.3+3.2 years) without dementia. All the patients received therapy with levodopa at a mean daily dose of 667.8 mg; 98 of them had the drug in combination with dopamine receptor agonists at a stable dose. The unified PD rating scale, the PD sleep scale (PDSS), and the Epworth sleepiness scale (ESS) were applied. Nocturnal polysomnography (PSG) and the multiple sleep latency test (MSLT) were performed.

Results and discussion. There was daytime sleepiness in 44% of the patients: permanent sleepiness in 15%, sudden daytime sleep attacks (along with low daytime sleepiness (ESS) in 14%, and permanent drowsiness concurrent with sleep attacks in 15%. The PSG findings showed a decrease in sleep efficiency, an increase in the duration of the first stage of sleep, a reduction in the duration of the second and third sleep stages, an extension of rapid eye movement (REM) sleep latency, and frequent awakenings (sleep fragmentation). PSG also demonstrated REM sleep behavior disorders (RBD) in half of the examinees.

Patients with sleep attacks differed from those with permanent drowsiness without sleep attacks with more severe sleep disorders (PDSS) and shorter sleep latency (MSLT). Patients with the RBD phenomenon had shorter sleep latency (MTLS) than those without this parasomnia. Patients with moderate or severe sleepiness (ESS scores of >10) differed from those with milder drowsiness (ESS scores of 410) and a lower representation of the third sleep stage.

Conclusion. There is evidence for the association of daytime sleepiness in PD with reduced efficiency, changes in the nighttime sleep pattern, and RBD.

About the Authors

M. R. Nodel
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery, Faculty of General Medicine. Research Department of Neurology, Science and Technology Park for Biomedicine.

1-211, Rossolimo St., Build. 1, Moscow 119021; 316, First Leonov St., Moscow 129226



K. V. Shevtsova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery, Faculty of General Medicine.

1-211, Rossolimo St., Build. 1, Moscow 119021



G. V. Kovrov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Research Department of Neurology, Science and Technology Park for Biomedicine.

1-211, Rossolimo St., Build. 1, Moscow 119021



N. N. Yakhno
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery, Faculty of General Medicine. Research Department of Neurology, Science and Technology Park for Biomedicine.

1-211, Rossolimo St., Build. 1, Moscow 119021



References

1. Gallagher DA, Lees AJ, Schrag A. What are the most important nonmotor symptoms in patients with Parkinson's disease and are we missing them? MovDisord. 2010 Nov 15; 25(15):2493-500.

2. Sobreira-Neto MA, Pena-Pereira MA, Sobreira EST, et al. High Frequency of Sleep Disorders in Parkinson's Disease and Its Relationship with Quality of Life. Eur Neurol. 2017;78(5-6):330-337. doi: 10.1159/000481939. Epub 2017 Oct 30.

3. Wienecke M, Werth E, Poryazova R, et al. Progressive dopamine and hypocretin deficiencies in Parkinson's disease: is there an impact on sleep and wakefulness? Sleep Res. 2012 Dec; 21(6):710-7.

4. Suzuki K, Okuma Y, Uchiyama T, et al. Impact of sleep-related symptoms on clinical motor subtypes and disability in Parkinson's disease: a multicentre cross-sectional study. JNeurolNeurosurgPsychiatry. 2017 Nov;88(11): 953-959.

5. Suzuki K, Miyamoto T, Miyamoto M, et al. Excessive daytime sleepiness and sleep episodes in Japanese patients with parkinson's disease. J Neurol Sci. 2008 Aug 15;271(1-2):47-52. doi: 10.1016/jjns.2008.03.008. Epub 2008 Apr 23.

6. Brodsky MA, Godbold J, Roth T, Oanow CW. Sleepiness in parkinson's disease: a controlled study. Mov Disord. 2003 Jun; 18(6):668-72.

7. Tandberg E, Larsen JP, Karlsen K. Excessive daytime sleepiness and sleep benefi in parkinson's disease: a community-based study. Mov Disord. 1999 Nov;14(6):922-7.

8. Gjerstad M, Aarsland D, Larsen JP. Development of daytime somnolence over time in parkinsons disease. Neurology. 2002 May 28;58(10):1544-6.

9. Amosova AN, Smolentseva IG, Guseinova PM, et al. Sleep disorders at an early stage of Parkinson's disease in patients who do not take antiparkinsonic drugs. Zhurnal nevrologii ipsikhiatrii im. S.S. Korsakova. 2016; 116(6):77-81. (In Russ.).

10. Nodel' MR, Rusakova IM, Yakhno NN. Clinical assessment of sleep and wake disorders in Parkinson's disease. Nevrologicheskii zhurnal. 2010;(2):19-25. (In Russ.).

11. Nodel' MR, Shevtsova KV. Hypersomnia in Parkinson's disease: diagnosis, pathophysiology, approaches to therapy. Nevrologicheskii Zhurnal. 2017;(2):57-63. (In Russ.).

12. Frucht S, Rogers JD, Greene PE, et al. Falling asleep at the wheel: motor vehicle mishaps in persons taking pramipexole and ropinirole. Neurology. 1999 Jun 10;52(9): 1908-10.

13. De Cock VC, Vidailhet M, Arnulf I. Sleep disturbances in patients with parkinsonism. Nat Clin Pract Neurol. 2008 May;4(5): 254-66. doi: 10.1038/ncpneuro0775. Epub 2008 Apr 8.

14. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991 Dec;14(6):540-5.

15. Littner MR, Kushida C, Wise M, et al. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep. 2005 Jan;28(1):113-21.

16. Koval'zon VM, Zavalko IM. Neurochemistry of sleep—wake—sleep cycle and Parkinson's disease. Neirokhimiya. 2013;(3): 193-206. (In Russ.)

17. Rye DB. Two faces of Eve: dopamine modulations of wakefulness and sleep. Neurology. 2004 Oct 26;63(8 Suppl 3):S2-7.

18. Thannickal TC, Lai YY, Seigel JM, et al. Hipocretin (orexin) cell loss in Parkinson's disease. Brain. 2007 Jun;130(Pt 6):1586-95. Epub 2007 May 9.

19. Wienecke M, Werth E, Poryazova R, et al. Progressive dopamine and hypocretin deficiencies in Parkinson's disease: is there an impact on sleep and wakefulness? Sleep Res. 2012 Dec; 21(6):710-7.

20. Ataide M, Franco CM, Lins OG. Daytime sleepiness and Parkinson's disease: the contribution of the multiple sleep latency test. Sleep Disord. 2014;2014:767181. doi: 10.1155/2014/767181. Epub 2014 Jul 10.

21. Nodel' MR, Yakhno NN, Ukraintseva YuV, Dorokhov VB. Insomnia in Parkinson's disease and its impact on the quality of life of patients. Nevrologicheskii zhurnal. 2014;(4):19-27. (In Russ.).

22. Litvinenko IV, Krasakov IV, Tikhomirova OV. Sleep disorders in patients with dementia in Parkinson's disease. Zhurnal nevrologii ipsikhia-trii im. S.S. Korsakova. 2011;111(9):37-42. (In Russ.).

23. Moller JC, Unger M, Stiasny-Kolster K. Continuous sleep EEG monitoring in PD patients with and without sleep attaks. Parkinsonism Relat Disord. 2009 Mar;15(3): 238-41. doi: 10.1016/j.parkreldis.2008.05.009. Epub 2008 Jul 10.

24. Arnulf I, Konofal E, Merino-Andreu M, et al. Parkinson's disease and sleepiness: an integral part of PD. Neurology. 2002 Apr 9; 58(7):1019-24.

25. Rye DB. Excessive daytime sleepiness and unintended sleep in Parkinson's disease. Curr NeurolNeurosci Rep. 2006 Mar;6(2):169-76.

26. Mahale R, Yadav R, Pal PK. Rapid eye movement sleep behaviour disorder in young-and older-onset Parkinson disease: a questionnaire-based study. Sleep Med. 2014 Jun;15(6): 642-6. doi: 10.1016/j.sleep.2014.01.022. Epub 2014 Mar 31.

27. Ford AH, Duncan GW, Firbank MJ, et al. Rapid eye movement sleep behavior disorder in Parkinson disease: magnetic resonance imaging study. Mov Disord. 2013 Jun;28(6):832-6. doi: 10.1002/mds.25367. Epub 2013 Feb 28.

28. Iranzo A, Tolosa E, Chaudhury KR, et al. REM sleep behavior disorder in Parkinson's disease. In: Non-motor symptoms of Parkinson's Disease. Oxford University Press; 2009. P. 205-13.

29. Neikrug AB, Maglione JE, Liu L, et al. Effects of sleep disorders on the non-motor symptoms of Parkinson disease. JClin Sleep Med. 2013 Nov 15;9(11):1119-29. doi: 10.5664/jcsm.3148.

30. Fahn S, Elton RL; UPDRS Development Committee. Unifid Parkinson's disease rating scale. In: Fahn S, Marsden CD, Calne DB, Goldstein M, editors. Recent developments in parkinson's disease. Florham Park: Macmillan; 1987. P. 153-63.

31. Chaudhuri KR, Pal S, DiMarco A, et al. The Parkinson's disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2002 Dec;73(6):629-35.

32. Iber C, Ancoli-Israel S, Chesson AL, Quan SF. American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications. Westchester: American Academy of Sleep Medicine; 2007.

33. Kovrov GV. Methods of diagnosis of sleep disorders. In: Kovrov GV, editor. Kratkoe rukovodstvo po klinicheskoi somnologii [Concise manual of clinical sleep medicine]. Moscow: MEDpress-inform; 2018. 272 p.

34. Kryger M, Roth T, Dement W, editors. Principles and Practice of Sleep Medicine. 5th edition. Philadelphia: Saunders/Elsevier; 2010.1766 p.

35. Ylikoski A, Martikainen K, Partinen M. Parkinson's disease and restless legs syndrome. Eur Neurol. 2015;73(3-4):212-9. doi: 10.1159/000375493. Epub 2015 Mar 11.

36. Golubev VL, Yakhno NN. Night sleep in Parkinson's disease. In: Son i ego narusheniya [Sleep and its disorders]. Moscow: Meditsina; 1972. P. 138-41.

37. Gjerstad MD, Wentzel-Larsen T, Aarsland D, Larsen JP. Insomnia in Parkinson's disease: frequency and progression over time. J Neurol Neurosurg Psychiatry. 2007 May;78(5): 476-9. Epub 2006 Nov 10.

38. Bhidayasiri R, Trenkwalder C. Getting a good night sleep? The importance of recognizing and treating nocturnal hypokinesia in Parkinson's disease. Parkinsonism Relat Disord. 2018 May;50:10-18. doi: 10.1016/j.parkreldis.2018.01.008. Epub 2018 Jan 5.

39. De Cock VC. Objective measures of the sleep-wake cycle in Parkinsons disease. In: Videnovic A, Hogl B, editors. Disorders of sleep and circadian rhythms in Parkinson's disease. Springer; 2015. 51-60.

40. Nodel' MR, Yakhno NN, Ukraintseva YuV. Hypersomnia in Parkinson's disease. Nevrologicheskiizhurnal. 2014;(6):9-16. (In Russ.).

41. Merino-Andrew M, Arnulf I, Konofal E. Unawareness of naps in parkinson's disease and in disorders with excessive daytime sleepiness. Neurology. 2003 May 13;60(9):1553-4.

42. Tavora DG, de Bruin VM, Lopes Gama R, et al. The nature of excessive sleepiness and sudden sleep onset in Parkinson’s disease. Sleep Sci. 2014 Mar;7(1):13-8. doi: 10.1016/j.slsci.2014.07.020. Epub 2014 Aug 22.

43. Zhu K, Van Hilten JJ, MarinusJ. Course and risk factors for excessive daytime sleepiness in Parkinson's disease. Parkinsonism Relat Disord. 2016 Mar;24:34-40. doi: 10.1016/j.parkreld-is.2016.01.020. Epub 2016 Jan 22.

44. Stevens S, Comella CL, Stepanski EJ. Daytime sleepiness and alertness in patients with Parkinson disease. Sleep. 2004 Aug 1; 27(5):967-72.

45. Nodel' MR, Yakhno NN, Ukraintseva YuV. Behavior disorder syndrome in the sleep phase with rapid eye movements in Parkinson's disease. Nevrologicheskii zhurnal. 2015;20(6):28-34. (In Russ.).

46. De Cock VC, Vidailhet M, Leu S, et al. Restoration of normal muscle controlin Parkinson's disease during REMsleep. Brain. 2007 Feb;130(Pt 2):450-6.

47. Nodel' MR. Hypersomnia and circadian disturbances in Parkinson’s disease. Nevrologiya, neiropsikhiatriya, psikhoso-matika = Neurology, Neuropsychiatry, Psychosomatics. 2016;8(4):45-50. (In Russ.). Doi: 10.14412/2074-2711-2016-4-45-50

48. Ferreira JJ, Katzenschlager R, Bloem BR, et al. Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson's disease. Eur J Neurol. 2013 Jan;20(1):5-15. doi: 10.1111/j.1468-1331.2012.03866.x.

49. Nodel' MR, Kovrov GV. Sleep disorders in Parkinson's disease: approaches to treatment and prevention. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2017;9(4):88-94. (In Russ.). Doi: 10.14412/2074-2711-2017-4-88-84

50. Нодель МР. Современные возможности терапии нарушений сна у пациентов с болезнью Паркинсона. Неврология, нейропсихиатрия, психосоматика. 2013;5(2):30-4. [Nodel' MR. Current possibilities of therapy for sleep disorders in Parkinson's disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2013;5(2):30-4. (In Russ.)]. doi: 10.14412/2074-2711-2013-2409

51. Loddo G, Calandra-Buonaura G, Sambati L, et al. The Treatment of Sleep Disorders in Parkinson's Disease: From Research to Clinical Practice. Front Neurol. 2017 Feb 16;8:42. doi: 10.3389/fneur.2017.00042.eCollection 2017.

52. Chaudhuri KR, Martinez-Martin P, Rolfe KA, et al. Improvements in nocturnal symptoms with ropinirole prolonged release in patients with advanced Parkinson's disease. Eur J Neurol. 2012 Jan;19(1):105-13. doi: 10.1111/j.1468-1331.2011.03442.x. Epub 2011 Jun 23.

53. Nodel' MR, Yakhno NN. Mirapex (pramipexol) in the treatment of non-motor disorders in Parkinson's disease. Zhurnal nevrologii ipsikhiatrii im. S.S. Korsakova. 2008;108(5):32-8. (In Russ.).

54. Holshoe JM. Antidepressants and sleep: a review. PerspectPsychiatr Care. 2009 Jul;45(3): 191-7. doi: 10.1111/j.1744-6163.2009.00221.x.

55. Videnovic A, Noble C, Reid KJ, et al Circadian melatonin rhythm and excessive daytime sleepiness in Parkinson disease. JAMA Neurol. 2014 Apr;71(4):463-9. doi: 10.1001/jamaneurol.2013.6239.

56. Kunz D, Mahlberg R. A two-part, doubleblind, placebo-controlled trial of exogenous melatonin REM sleep behavior disorder. J Sleep Res. 2010 Dec;19(4):591-6. doi: 10.1111/j.1365-2869.2010.00848.x.

57. Morgenthaler T, Kramer M, Alessi C, et al. Practice parameters for the psychological and behavioral treatment of insomnia: an update. An American Academy of Sleep Medicine Report. Sleep. 2006 Nov;29(11):1415-9.

58. Qaseem A, Kansagara D, Forciea MA, et al. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016 Jul 19;165(2):125-33. doi: 10.7326/M15-2175. Epub 2016 May 3.

59. Riemann D, Nissen C, Palagini L, et al. The neurobiology, investigation, and treatment of chronic insomnia. Lancet Neurol. 2015 May; 14(5):547-58. doi: 10.1016/S1474-4422(15)00021-6. Epub 2015 Apr 12.

60. Kotschet K, Johnson W, Mc Gregor S, et al. Daytime sleep in Parkinson's disease measured by episodes of immobility. Parkinsonism Relat Disord. 2014 Jun;20(6):578-83. doi: 10.1016/j.parkreldis.2014.02.011. Epub 2014 Feb 24.


For citation:


Nodel M.R., Shevtsova K.V., Kovrov G.V., Yakhno N.N. Nighttime sleep disorders in patients with daytime sleepiness in Parkinson s disease. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(4):23-29. (In Russ.) https://doi.org/10.14412/2074-2711-2018-4-23-29

Views: 297


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)