The factors impact on the urgent daytime sleepiness degree in the Parkinson’s disease

Close metadata

OBJECTIVE

Describe the clinical and physiological features of patients with different types of SOS for detection of influencing factors of urgent EDS.

MATERIAL AND METHODS

32 patients SOS positive (17 female) were included. The median age was 66.5±7.8; the median PD duration was 9.2±4.3 years (2.66±0.5 Hoehn—Yahr). The patients received the levodopa — dopamine receptors agonist combined medications. Moreover, the Unified Parkinson’s disease rating scale (UPDRS parts II, III in an «on» state of dopaminergic medication), the diary of the assessment of the waking period, the Epworth Sleepiness Scale, the Parkinson Disease Sleep Scale I (PDSS I), the Scales for Outcomes of Parkinson’s disease-Cognition (SCOPA-Cog), the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Apathy Scale, the Stroop test, objective sleep-wake assessment: standard nocturnal video-polysomnography (PSG), multiple sleep latency tests (MSLT) were used. Besides, we compare patients’ clinical and neuropsychological characteristics (especially EDS sense) before the SOS.

RESULTS

36% of patients describe the SOS without preexisting sleepiness (group 1). The short-time period of sleepiness notes approximately 64% SOS patients before the sleeping period (group 2). Group 1 has the less prominent activity of daily living compared to group 2. Moreover, group 1 patients have significantly lower subjective and objective severity of night sleep disorders (higher total score value of SOS BP, longer 3rd stage of sleep duration), lesser severity of the Epworth and apathy scale (p<0.05). The group 2 patients with a low ability to resist the onset of SOS (less than 5 minutes) differed from patients with greater resistance. Firstly, by a greater degree of disturbances in daily activities (ASOBP, section 2), shorter latent periods 1, 3 stages, shorter duration of 1 stage of night sleep; more prominent anxiety, depression and impaired attention (p<0.05). The narcoleptic-like falling asleep syndrome was diagnosed in 9 (28%) cases with SOS, without significant difference between the groups.

CONCLUSION

SOS among patients without EDS are an independent manifestation of PD. The degree of SOS urgency is affected by the severity of the activity of daily living, anxiety, depression, and attention disorders.

Keywords:

Parkinson’s’ Disease

excessive daytime sleepiness

sleep attacks

unintended sleep episodes

Authors:

Nodel M.R.

Sechenov First Moscow State Medical University

Shevtsova K.V.

Sechenov First Moscow State Medical University (Sechenov University)

Kovrov G.V.

State Scientific Center of the Russian Federation — Institute of Biomedical Problems of the Russian Academy of Sciences

Received:

28.03.2022

Accepted:

27.04.2022

List of references:

Nodel MR, Yakhno NN, Ukraintseva UV. Hypersomnia in Parkison’s disease. Neurological Journal. 2014;19(6):9-16. (In Russ.).
Tandberg E, Larsen JP, Karlsen K. Excessive daytime sleepiness and sleep benefi in parkinson’s disease: a community-based study. Mov Disord. 1999;14(6):922-927.
Frucht S, Rogers JD, Greene PE, et al. Falling asleep at the wheel: motor vehicle mishaps in persons taking pramipexole and ropinirole. Neurology. 1999;52(9):1908-19100.
De Cock VC, Vidailhet M, Arnulf I. Sleep disturbances in patients with parkinsonism. Nat Clin Pract Neurol. 2008;4:b254-66.
Ghorayeb I, Loundou A, Auquier P, et al. A nationwide survey of excessive daytime sleepiness in Parkinson’s disease in France. Mov Disord. 2007;22:1567-1572. https://doi.org/10.1002/mds.21541
Abbott R, Ross G, White I. Excessive daytime sleepiness and subsequent development of parkinson’s disease. Neurology. 2005;65:1442-1446.
Rye DB. Two faces of Eve: dopamine modulations of wakefulness and sleep. Neurology. 2004;64:2-7.
Razmy A, Lang AE, Shapiro CM. Predictors of impaired daytime sleep and wakefulness in patients with parkinsons disease treated with ergot vs non ergot dopamine agonists. Arch Neurol. 2004;61:97-102.
Ondo WG, Dat. Vuong K, Khan H, et al. Daytime sleepiness and other sleep disorders in parkinson’s disease. Neurology. 2001;57:1392-1396.
Salawu F, Olokoba A. Excessive Daytime Sleepiness and Unintended Sleep Episodes Associated with Parkinson’s Disease. Oman Med J. 2015;30(1):3-10.
Rye DB. Excessive daytime sleepiness and unintended sleep in Parkinson’s disease. Curr Neurol Neurosci Rep. 2006;6(2):169-176.
Baumann C, Ferini-Strambi L, Waldvogel D. Parkinsonism with excessive daytime sleepiness-a narcolepsy-like disorder? J Neurol. 2005;252(2):139-145.
Kaynak D, Kiziltan G, Kaynak H, et al. Sleep and sleepiness in patients with Parkinson’s disease before and after dopaminergic treatment. European Journal of Neurology. 2005;12(3):199-207.
Kovalzon VM, Zavalko IM. Neurochemistry of the wakefulness-sleep cycle and Parkinson’s disease. Neurochemistry.2013;30(3):193-206. (In Russ.).
Thannickal TC, Lai YY, Seigel JM, et al. Hipocretin (orexin) cell loss in Parkinson’s disease. Brain. 2007;130:1577-1595.
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;21(6):710-717.
Poryazova R, Benninger D, Waldvogel D, et al. Excessive daytime sleepiness in parkinson’s disease: characteristics and determinants. European Neurology. 2010;63(3):129-135.
Tomlison CL, Stove R, Patel S, et al. Systematic review of levodopa dose equivalency. Movement disorders. 2010;86(7):2649-2653.
Fahn S, Elton RL. UPDRS Development Committee. Unifid Parkinson’s disease rating scale. In: Fahn S., Marsden C.D., Calne D.B., Goldstein M. eds. Recent developments in parkinson’s disease. Florham Park, N.J.: Macmillan; 1987;153-163.
Chaudhuri KR, Pal S, Di Marco 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;73(6):629-635.
Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540-545.
Marinus J, Visser M, Martínez-Martín P, et al. A short psychosocial questionnaire for patients with Parkinson’s disease: the SCOPA-PS J Clin Epidemiol. 2003;56(1):61-67.
Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. J Pers Assess. 1996;67(3):588-597.
Spielberger CD, Gorsuch RL, Lushene R, et al. 1983. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
Starkstein SE, Mayberg HS, Preziosi TJ, et al. Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J Neuropsychiatry Clin Neurosci Spring. 1992;4(2):134-139.
Van der Elst W, Van Boxtel MP, Van Breukelen GJ, et al. The Stroop color-word test: influence of age, sex, and education; and normative data for a large sample across the adult age range. Assessment. 2006;13(1):62-79.
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;28(1)113-121.
Iber C, Ancoli-Israel S, Chesson AL, et al. 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.
Kotschet K, Johnson W, McGregor S, et al. Daytime sleep in Parkinson’s disease measure by episodes of immobility. Parkinsonism Relat Disord. 2014;20(6):578-583.
Bargiotas P, Bargiotas I, Debove I, et al. Sleep apnea syndrome and subthalamic stimulation in Parkinson’s disease. Sleep Med. 2021;86:106-112.
Phattanarudee S, Sangthong S, Bhidayasiri R. Association between Sleep Disturbances and Daytime Somnolence in Parkinson’s Disease Eur Neurol. 2018;80(5-6):268-276.
Arnulf I, Konofal E, Merino-Andreu M, et al. Parkinson’s disease and sleepiness: an integral part of PD. Neurology. 2002;58(7):1019-1024.
Shpirer I, Miniovitz A, Klein C, et al. Excessive daytime sleepiness in patients with Parkinson’s disease: a polysomnography study. Mov Disord. 2006;21(9):1432-1438.
Rissling I, Körner Y, Geller F, et al. Preprohypocretin polymorphisms in Parkinson disease patients reporting «sleep attacks». Sleep. 2005;28(7):871-875.
Nodel MR, Shevtsova KV, Kovrov GV, Yakhno NN. Unexpected falling asleep in patients with Parkinson’s disease. Russian Neurological Journal. 2022;27(1):62-68. (In Russ.).
Arnulf I, Konofal E, Merino-Andreu M, et al. Parkinson’s disease and sleepiness: an integral part of PD. Neurology. 2002;58(7):1019-1024.
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;7(1):13-18.
Buskova J, Klempır J, Majerova V, et al. Sleep disturbances in untreated Parkinson’s disease. Journal of Neurology. 2011;258(12):2254-2259.
Thobois S, Prange S, Sgambato-FaureV, et al. Imaging the Etiology of Apathy, Anxiety, and Depression in Parkinson’s Disease: Implication for Treatment. Curr Neurol Neurosci Rep. 2017;18;17(10):76.
Nodel MR. The influence of neuropsychiatric disorders on the quality of life of patients with Parkinson’s disease. Neurological Journal. 2015;20(1):20-27. (In Russ.).
Nodel MR, Yakhno NN. Apathy in Parkinson’s disease. Neurological Journal. 2014;1:9-15. (In Russ.).
Nodel MR, Yakhno NN, Ukraintseva UV. REM sleep behavior disorder in Parkison’s disease. Neurological Journal. 2015;20(6):28-34. (In Russ.).
Nodel MR, Shevtsova KV, Kovrov GV, Yakhno NN. Night sleep disorders in patients with daytime sleepiness in the disease Parkinson’s disease. Neurology. Neuropsychiatry. Psychosomatics. 2018;10(4):23-29. (In Russ.).

Close metadata