Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Warszawa, Poland.
Pharmacol Rep. 2013;65(3):614-23. doi: 10.1016/s1734-1140(13)71038-7.
Sleep disorders are highly prevalent among patients with Parkinson's disease (PD). Chronic medication with L-dopa may be one of the factors that contributes to poor sleep quality. The aim of this study was to assess the effects of long term use of L-dopa on objective and subjective measures of sleep quality in PD patients.
Twenty-seven PD patients (mean age 62.5 ± 8.6 years, mean disease duration 7.3 ± 5.9 years, 11 females) underwent nocturnal polysomnography. Their sleep was rated subjectively using the Parkinson's disease sleep scale (PDSS), and their disease severity was assessed using the unified Parkinson's disease severity scale (UPDRS) standard questionnaire. Doses of L-dopa and other medications were correlated with parameters of sleep quality. The polysomnographic recordings were compared with those from 24 age- and gender-matched normal controls.
The patients showed decreased total sleep time (TST) and sleep efficiency (SE), prolonged sleep onset and REM sleep latency and wake after sleep onset (WASO). Parts I-III of the UPDRS scores correlated with TST, SE and WASO but not with PDSS scores. L-dopa dosage and part IV of the UPDRS correlated with PDSS scores but not with polysomnographic parameters.
Higher doses of chronically administered L-dopa correlated with lower sleep quality according to the subjective measures but not according to the polysomnographic parameters, which were related to the severity of PD symptoms. The low sleep quality according to the subjective measurements may result from complications of therapy at high doses of L-dopa.
睡眠障碍在帕金森病（PD）患者中非常普遍。长期使用左旋多巴可能是导致睡眠质量下降的因素之一。本研究旨在评估长期使用左旋多巴对 PD 患者客观和主观睡眠质量测量的影响。
27 名 PD 患者（平均年龄 62.5 ± 8.6 岁，平均病程 7.3 ± 5.9 年，女性 11 名）接受了夜间多导睡眠图检查。他们的睡眠质量通过帕金森病睡眠量表（PDSS）进行主观评估，疾病严重程度通过统一帕金森病严重程度量表（UPDRS）标准问卷进行评估。左旋多巴和其他药物的剂量与睡眠质量参数相关。将多导睡眠图记录与 24 名年龄和性别匹配的正常对照者进行比较。
患者的总睡眠时间（TST）和睡眠效率（SE）降低，睡眠潜伏期和 REM 睡眠潜伏期以及睡眠后觉醒时间（WASO）延长。UPDRS 评分的 I-III 部分与 TST、SE 和 WASO相关，但与 PDSS 评分无关。左旋多巴剂量和 UPDRS 评分的 IV 部分与 PDSS 评分相关，但与多导睡眠图参数无关。
根据主观测量，慢性给予较高剂量的左旋多巴与睡眠质量较低相关，但与多导睡眠图参数无关，而多导睡眠图参数与 PD 症状的严重程度相关。根据主观测量的低睡眠质量可能是由于高剂量左旋多巴治疗的并发症所致。
