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帕金森病患者日间过度嗜睡的临床预测因素

Clinical Predictors of Excessive Daytime Sleepiness in Patients with Parkinson's Disease.

作者信息

Junho Bruno Terra, Kummer Arthur, Cardoso Francisco, Teixeira Antonio Lucio, Rocha Natalia Pessoa

机构信息

Laboratório Interdisciplinar de Investigação Médica (LIIM), Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Eli Lilly and Company do Brasil, São Paulo, SP, Brazil.

出版信息

J Clin Neurol. 2018 Oct;14(4):530-536. doi: 10.3988/jcn.2018.14.4.530. Epub 2018 Sep 6.

Abstract

BACKGROUND AND PURPOSE

Excessive daytime sleepiness (EDS) is a common complaint among patients with Parkinson's disease (PD). Several factors have been associated with EDS in PD, especially neuropsychiatric symptoms. This study aimed to determine the relationships between neuropsychiatric symptoms, sociodemographic and clinical parameters, and EDS in PD.

METHODS

This cross-sectional study analyzed 85 patients with PD. All patients underwent socioeconomic and clinical data evaluations followed by a psychiatric interview and a neurological examination, including the assessment of sleep features. Patients were divided into two groups according to the presence or absence of EDS, which was defined as a score higher than 10 on the Epworth Sleepiness Scale. Binary logistic regression was performed in order to describe the predictors of EDS.

RESULTS

We found that EDS affects 40% of PD patients and is associated with older age, restless legs syndrome, depressive and anxious symptoms, and worse sleep quality. In the multivariate analysis, older age, levodopa use, and worse sleep quality remained as significant predictors of EDS in PD.

CONCLUSIONS

Nighttime sleep problems, older age, and levodopa use are significantly associated with EDS in PD. A careful assessment and the management of sleep problems in PD patients might help to improve their quality of life.

摘要

背景与目的

日间过度嗜睡(EDS)是帕金森病(PD)患者的常见主诉。PD患者的EDS与多种因素相关,尤其是神经精神症状。本研究旨在确定PD患者神经精神症状、社会人口统计学和临床参数与EDS之间的关系。

方法

本横断面研究分析了85例PD患者。所有患者均接受社会经济和临床数据评估,随后进行精神科访谈和神经科检查,包括睡眠特征评估。根据Epworth嗜睡量表评分是否高于10分,将患者分为有或无EDS两组。采用二元逻辑回归分析来描述EDS的预测因素。

结果

我们发现EDS影响40%的PD患者,且与年龄较大、不安腿综合征、抑郁和焦虑症状以及较差的睡眠质量相关。在多变量分析中,年龄较大、使用左旋多巴以及较差的睡眠质量仍然是PD患者EDS的显著预测因素。

结论

夜间睡眠问题、年龄较大和使用左旋多巴与PD患者的EDS显著相关。对PD患者的睡眠问题进行仔细评估和管理可能有助于改善他们的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53ae/6172509/ce77db279758/jcn-14-530-g001.jpg

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