Sleep disturbances in Parkinson’s disease – subjective and objective data
Jakoubková M., Šonka K., Roth J., Růžička E., Jech R., Volfová M., Mečíř P.,
Neurologická klinika 1. LF UK a VFN, Praha |
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Summary:
Introduction: The aim of this study was to compare the data from clinical history with the results of
nocturnal polysomnography in patients with Parkinson’s disease. Methods: A total of 15 patients (7
females, 8 males, age 56.5 ± 8.5 years, mean ± SD, average lenght of treatment 4.3 ± 2.8 ys) were examined
with medical history focused on sleep disturbances and with nocturnal polysomnography. Hoehn-Yahr
rating was 2.3 ± 0.4 (range 1.5–3). Eleven patients were on L-DOPA monotherapy, 4 patients on L-DOPA
+ dopamine agonist therapy. Results: Focused clinical history showed that 12 out of 15 patients suffer
with at least one of the sleep disturbances followed. Subjectively, prolonged falling asleep was the most
bothersome (7 patients). In 4 patients, sleep was subjectively disturbed by apnoeic pauses and 8 patients
gave at least one of the possible signs of REM behaviour disorder. Polysomnography did not show
evidence of more difficult falling asleep. In all patients, polysomnography detected low quality of sleep
architecture with frequent waking reactions or awakenings, with reduction of deep synchronous sleep
and reduction of REM sleep and with proportionately significant occurrence of wakefulness. Sleep
apnoea syndrome was found in 6 patients, periodic limb movements in sleep in 4 patients and REM
behaviour disorder in 4 patients. Based on clinical history, sleep apnoea syndrome was suspected in
67 % and periodic limb movements in sleep in 50 %. Suspicion of REM behaviour disorder was made in
8 patients but insufficient atony was found in 4 patients.Conclusion:Focused clinical history can detect
with considerable sensitivity selected sleep disturbances in Parkinson’s disease patients.
Key words:
Parkinson’s disease, sleep disturbances, sleep apnoea syndrome, periodic leg movements in
sleep, REM behaviour disorder
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