Background

Sleep disorders negatively impact quality of life in Parkinson’s disease (PD), yet the role of antiparkinsonian drugs on sleep quality is still unclear. We aimed to explore the correlation between sleep dysfunction and dopaminergic therapy in a large cohort of advanced PD patients.

Methods

Patients consecutively evaluated for device-aided therapies eligibility were evaluated by means of the PD Sleep Scale (PDSS-2; score ≥ 18 indicates poor sleep quality), and the Epworth Sleepiness Scale (ESS score ≥ 10 indicates excessive daytime sleepiness—EDS).

Binary logistic regression analysis, adjusting for age, sex, disease duration, motor impairment, and sleep drugs, was employed to evaluate the association between dopaminergic therapy and PDSS-2 and ESS scores. Analysis of covariance assessed differences in PDSS-2 and ESS scores between patients without DA, and between patients treated with low or high doses of DA (cut-off: DA-LEDD = 180 mg).

Results

In a cohort of 281 patients, 66.2% reported poor sleep quality, and 34.5% reported EDS. DA treatment demonstrated twofold lower odds of reporting relevant sleep disturbances (OR 0.498; p = 0.035), while DA-LEDD, levodopa-LEDD, total LEDD, and extended-release levodopa were not associated with disturbed sleep. EDS was not influenced by dopaminergic therapy. Patients with DA intake reported significant lower PDSS-2 total score (p = 0.027) and “motor symptoms at night” domain score (p = 0.044). Patients with higher doses of DA showed lower PDSS-2 total score (p = 0.043).

Conclusion

Our study highlights the positive influence of DA add-on treatment on sleep quality in this group of advanced fluctuating PD patients.

中文翻译：

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多巴胺能治疗对波动性帕金森病患者睡眠质量的影响

背景

睡眠障碍会对帕金森病 (PD) 的生活质量产生负面影响，但抗帕金森病药物对睡眠质量的作用仍不清楚。我们的目的是在一大群晚期帕金森病患者中探讨睡眠功能障碍与多巴胺能治疗之间的相关性。

方法

通过PD睡眠量表（PDSS-2；评分≥18表示睡眠质量差）和Epworth嗜睡量表（ESS评分≥10表示日间过度嗜睡——EDS）对连续评估设备辅助治疗资格的患者进行评估。

采用二元逻辑回归分析，调整年龄、性别、病程、运动障碍和睡眠药物，评估多巴胺能治疗与 PDSS-2 和 ESS 评分之间的关​​联。协方差分析评估了未使用 DA 的患者以及接受低剂量或高剂量 DA 治疗的患者之间 PDSS-2 和 ESS 评分的差异（截止值：DA-LEDD = 180 mg）。

结果

在 281 名患者的队列中，66.2% 的患者报告睡眠质量差，34.5% 的患者报告 EDS。 DA 治疗显示报告相关睡眠障碍的几率降低了一倍（OR 0.498；p = 0.035），而 DA-LEDD、左旋多巴-LEDD、总 LEDD 和缓释左旋多巴与睡眠障碍无关。 EDS 不受多巴胺能治疗的影响。摄入 DA 的患者报告 PDSS-2 总分 (p = 0.027) 和“夜间运动症状”领域得分显着较低 (p = 0.044)。 DA 剂量较高的患者表现出较低的 PDSS-2 总分 (p = 0.043)。

结论

我们的研究强调了 DA 附加治疗对这组晚期波动性 PD 患者睡眠质量的积极影响。