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帕金森病中的主观睡眠功能障碍和失眠症状:来自法国CoPark队列横断面评估的见解

Subjective sleep dysfunction and insomnia symptoms in Parkinson's disease: Insights from a cross-sectional evaluation of the French CoPark cohort.

作者信息

Ratti Pietro-Luca, Nègre-Pagès Laurence, Pérez-Lloret Santiago, Manni Raffaele, Damier Philippe, Tison François, Destée Alain, Rascol Olivier

机构信息

Department of Clinical Pharmacology, Paul Sabatier University and Toulouse University Hospital, Toulouse, France; INSERM UMR825 Neuroimaging and Neurologic Diseases, Toulouse, France; Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Switzerland.

Department of Clinical Pharmacology, Paul Sabatier University and Toulouse University Hospital, Toulouse, France; LN-Pharma, Toulouse, France.

出版信息

Parkinsonism Relat Disord. 2015 Nov;21(11):1323-9. doi: 10.1016/j.parkreldis.2015.09.025. Epub 2015 Sep 10.

Abstract

INTRODUCTION

Twenty-seven to 80% of patients with Parkinson's Disease (PD) complain of subjective sleep dysfunction and insomnia symptoms. Our aim is to describe the prevalence and features of subjective sleep dysfunction and insomnia symptoms in patients with PD compared to other patients.

METHODS

Cross-sectional analysis of 636 adult PD patients compared to 143 age and sex-matched non-PD control patients consulting their general practitioners. Insomnia symptoms and other sleep features were assessed by the Pittsburgh Sleep Quality Index (PSQI), a global score > 5 defining impaired sleep. The Chi-square test or the Student's t-test were used to assess the potential clinical and demographic differences between groups and between PD patients with vs. without sleep dysfunction. Logistic regression analysis was employed to test multivariate effects.

RESULTS

Sleep dysfunction and insomnia symptoms were more frequent in PD patients compared to control patients (63 vs. 45%, p = 0.001). Female gender, PD duration, presence of depression and anxiety were associated with the presence of insomnia in PD. Subjective sleep efficiency, habitual sleep quality, sleep disturbance and daytime dysfunction, but not sleep latency, were reduced in PD patients compared to controls.

CONCLUSIONS

The prevalence of sleep dysfunction is higher in PD than in other general medical conditions. Insomnia in PD seems to affect sleep maintenance and consolidation, but not sleep onset.

摘要

引言

27%至80%的帕金森病(PD)患者主诉存在主观睡眠功能障碍和失眠症状。我们的目的是描述与其他患者相比,PD患者主观睡眠功能障碍和失眠症状的患病率及特征。

方法

对636例成年PD患者与143例年龄和性别匹配的非PD对照患者进行横断面分析,这些对照患者是向其全科医生咨询的。通过匹兹堡睡眠质量指数(PSQI)评估失眠症状和其他睡眠特征,PSQI总分>5定义为睡眠受损。采用卡方检验或学生t检验评估两组之间以及有与无睡眠功能障碍的PD患者之间潜在的临床和人口统计学差异。采用逻辑回归分析来检验多因素效应。

结果

与对照患者相比,PD患者的睡眠功能障碍和失眠症状更为常见(63%对45%,p = 0.001)。女性、PD病程、抑郁和焦虑的存在与PD患者失眠的存在相关。与对照组相比,PD患者的主观睡眠效率、习惯性睡眠质量、睡眠障碍和日间功能障碍降低,但睡眠潜伏期未降低。

结论

PD患者睡眠功能障碍的患病率高于其他一般医疗情况。PD患者的失眠似乎影响睡眠维持和巩固,但不影响入睡。

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