Höglund Arja, Hagell Peter, Broman Jan-Erik, Pålhagen Sven, Sorjonen Kimmo, Fredrikson Sten
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Neurology, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Parkinsons Dis. 2019 Sep 5;2019:5708515. doi: 10.1155/2019/5708515. eCollection 2019.
The aim of this prospective study was to investigate excessive daytime sleepiness (EDS) over time and in relation to other PD symptoms among people with Parkinson's disease (PD).
Thirty participants younger than 65 years with PD were randomly selected. At inclusion, mean (SD) disease duration was 6.2 (4.8) years and median (min-max) severity of PD was classified as stage II (stages I-III) according to Hoehn and Yahr. Participants were followed annually for 10 years with clinical assessments of their PD status, medications, comorbidities, and a standardized interview about their sleep habits and occurrence of daytime sleepiness. EDS was assessed by the self-reported Epworth Sleepiness Scale (ESS). Seventeen participants completed the 10-year longitudinal follow-up.
Fifteen of 30 persons were classified to suffer from EDS (ESS > 10) at baseline. At the group level, EDS remained stable over 10 years and did not deteriorate in parallel with worsening of motor symptoms. Furthermore, EDS was associated with sleep quality, fatigue, anxiety, depression, and axial/postural/gait impairments.
EDS did not worsen over 10 years, although other PD aspects did. EDS in PD seems to be a complex nonmotor symptom that is unrelated to deterioration of motor symptoms in PD.
这项前瞻性研究的目的是调查帕金森病（PD）患者日间过度嗜睡（EDS）随时间的变化情况以及与其他PD症状的关系。
随机选取30名年龄小于65岁的PD患者。入组时，平均（标准差）病程为6.2（4.8）年，根据Hoehn和Yahr分级，PD的中位（最小-最大）严重程度被分类为II期（I-III期）。对参与者进行了为期10年的年度随访，包括对其PD状态、药物治疗、合并症的临床评估，以及关于他们睡眠习惯和日间嗜睡情况的标准化访谈。通过自我报告的爱泼沃斯思睡量表（ESS）评估EDS。17名参与者完成了10年的纵向随访。
30人中15人在基线时被分类为患有EDS（ESS>10）。在组水平上，EDS在10年期间保持稳定，并未随着运动症状的恶化而恶化。此外，EDS与睡眠质量、疲劳、焦虑、抑郁以及轴性/姿势/步态障碍相关。
尽管PD的其他方面有所恶化，但EDS在10年期间并未恶化。PD中的EDS似乎是一种复杂的非运动症状，与PD运动症状的恶化无关。
