Department of Neurology, Medical Faculty, PJ Safarik University Kosice, Trieda SNP 1, 040 01, Kosice, Slovakia.
J Neurol. 2011 Dec;258(12):2222-9. doi: 10.1007/s00415-011-6098-6. Epub 2011 May 26.
Sleep disturbances are common and often severe in patients with Parkinson's disease (PD) and their symptoms can be present at any time of day. The purpose of our study was to examine how excessive daytime sleepiness or poor nocturnal sleep quality and mood disorders influence the quality of life (QoL) in PD patients. Ninety-three PD patients from eastern Slovakia were recruited (49.5% males, mean age 68.0 ± 9.5 years, mean disease duration 6.1 ± 5.9 years). Sleep disturbances were measured using the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI); QoL with the Parkinson's Disease Quality of Life Questionnaire (PDQ-39); depression and anxiety with the Hospital Anxiety and Depression Scale (HADS) and disease severity with the Unified Parkinson's Disease Rating Scale (UPDRS). χ (2) test, bivariate correlations and multiple linear regressions were performed. PSQI and ESS had significant correlations with worse QoL (p < 0.01, p < 0.05, respectively). HADS-D (p < 0.01), HADS-A (p < 0.01), UPDRS (p < 0.01) and disease duration (p < 0.05) were also significantly related to worse QoL. In the linear regression analysis, however, only PSQI (p < 0.01), anxiety (p < 0.001) and UPDRS (p < 0.001) remained significant. The model with PSQI explained 74% of the variance, and the model with ESS explained 63% of the variance in PDQ-39 when analyses were performed separately. In an overall model, however, only PSQI remained significant, accounting for 82% of the variance in PDQ-39. Nighttime poor sleep and anxiety are important contributors leading to a worse QoL. As these are treatable conditions, they should be recognized by clinicians and managed properly.
睡眠障碍在帕金森病（PD）患者中很常见，且通常较为严重，其症状可能在一天中的任何时间出现。我们的研究目的是探讨日间过度嗜睡或夜间睡眠质量差和情绪障碍如何影响 PD 患者的生活质量（QoL）。我们招募了来自斯洛伐克东部的 93 名 PD 患者（49.5%为男性，平均年龄 68.0±9.5 岁，平均病程 6.1±5.9 年）。使用 Epworth 嗜睡量表（ESS）和匹兹堡睡眠质量指数（PSQI）评估睡眠障碍；使用帕金森病生活质量问卷（PDQ-39）评估 QoL；使用医院焦虑和抑郁量表（HADS）评估抑郁和焦虑，使用统一帕金森病评定量表（UPDRS）评估疾病严重程度。进行 χ (2)检验、双变量相关性分析和多元线性回归分析。PSQI 和 ESS 与较差的 QoL 有显著相关性（p<0.01，p<0.05）。HADS-D（p<0.01）、HADS-A（p<0.01）、UPDRS（p<0.01）和病程（p<0.05）也与较差的 QoL 显著相关。然而，在线性回归分析中，仅 PSQI（p<0.01）、焦虑（p<0.001）和 UPDRS（p<0.001）仍然具有统计学意义。当分别进行分析时，PSQI 模型解释了 PDQ-39 方差的 74%，ESS 模型解释了 PDQ-39 方差的 63%。然而，在综合模型中，只有 PSQI 仍然具有统计学意义，占 PDQ-39 方差的 82%。夜间睡眠质量差和焦虑是导致 QoL 下降的重要因素。由于这些是可治疗的疾病，临床医生应认识到这些问题并进行适当的管理。
