Ferreira J J, Desboeuf K, Galitzky M, Thalamas C, Brefel-Courbon C, Fabre N, Senard J-M, Montastruc J-L, Sampaio C, Rascol O
Neurological Clinical Research Unit, Lisbon School of Medicine, Lisbon, Portugal.
Eur J Neurol. 2006 Mar;13(3):209-14. doi: 10.1111/j.1468-1331.2006.01262.x.
Recent case reports of 'sleep attacks' (SA) in patients with Parkinson's disease (PD) generated concerns about drug-induced daytime somnolence in this population. However, there are nearly no comparative data on sleep and vigilance problems between PD patients and normal controls. We performed a cross-sectional survey in PD patients and age-matched controls using a structured questionnaire on PD history, treatments, co-morbidity, activities of daily living, habits, exercise, sleep pattern, driving, pre-existing nocturnal problems, daytime somnolence, episodes of SA and the circumstances in which such episodes occurred. Daytime somnolence was also measured with the Epworth Sleepiness Scale (ESS) and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). 176 PD patients and 174 controls were included. The same proportion of PD patients (27%) and controls (32%) reported episodes of SA, but these were more frequent in PD patients and occurred more frequently during situations requiring attention (10.8% vs. 1.7%, p<10(-3)). More PD patients had abnormal daytime somnolence (ESS) and poor sleeping quality (PSQI). The most consistent factor associated with SA was the duration of levodopa therapy and the predictive value of an abnormal ESS score was rather poor (40.7%). Abnormal daytime somnolence and poor sleep quality at night are more frequent in PD patients than in normals. However, SA are reported in both groups, although less frequently in the normals during activities that requires attention.
帕金森病（PD）患者出现“睡眠发作”（SA）的近期病例报告引发了对该人群药物诱导性日间嗜睡的担忧。然而，关于PD患者与正常对照之间睡眠和警觉问题的比较数据几乎没有。我们使用一份关于PD病史、治疗、合并症、日常生活活动、习惯、运动、睡眠模式、驾驶、既往夜间问题、日间嗜睡、SA发作及发作情况的结构化问卷，对PD患者和年龄匹配的对照进行了横断面调查。还使用爱泼华嗜睡量表（ESS）测量日间嗜睡情况，并用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。纳入了176例PD患者和174例对照。报告有SA发作的PD患者（27%）和对照（32%）比例相同，但SA在PD患者中更频繁，且在需要注意力的情况下更常发生（10.8%对1.7%，p<10⁻³）。更多PD患者存在异常的日间嗜睡（ESS）和较差的睡眠质量（PSQI）。与SA最一致相关的因素是左旋多巴治疗的持续时间，而ESS评分异常的预测价值相当低（40.7%）。PD患者比正常人更常出现异常的日间嗜睡和夜间睡眠质量差的情况。然而，两组均报告有SA，尽管在需要注意力的活动中正常人出现SA的频率较低。
