Qin Xiaoling, Li Xue, Chen Gang, Chen Xu, Shi Mingyu, Liu Xue-Kui, Li Zai-Li, Xin Zai-E, Gao Dianshuai
Department of Neurology, Shanghai 8 People's Hospital, Affiliated to Tongji University, No. 8 Caobao Road, Shanghai 200235, China.
Xuzhou Key Laboratory of Neurobiology, Department of Neurobiology and Anatomy, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China.
Parkinsons Dis. 2020 Sep 14;2020:6378673. doi: 10.1155/2020/6378673. eCollection 2020.
The present study investigated the clinical features and correlates of poor nighttime sleepiness (PNS) in patients with Parkinson's disease (PD).
One hundred ten patients with PD (divided into PD-PNS group and PD-nPNS group) and forty-seven controls (nPD-PNS group) were enrolled in this study. Demographic information was collected. Patients were assessed according to the unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr (H&Y) stage scale. Patients were also evaluated according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), rapid eye movement sleep behavior disorder screening questionnaire (RBD-SQ), restless leg syndrome (RLS) diagnosis, Hamilton's depression scale (HAMD), and Hamilton's anxiety scale (HAMA).
The prevalence of PNS was 55.45% (61/110) in patients with PD. The PD-PNS group tended to have a longer duration of disease, higher UPDRS-I and UPDRS-III scores, a higher percentage of RLS patients, and higher HAMA and HAMD scores than those of the PD-nPNS group. The PD-PNS group tended to have a higher percentage of RBD and RLS patients and higher HAMA and HAMD scores than those of the nPD-PNS group. Analysis of the PSQI components and PSQI impact factors showed that the PD-PNS group had worse subjective sleep quality ( = -2.267, = 0.023), shorter sleep latency ( = -2.262, = 0.024), fewer sleep medications ( = -4.170, ≤ 0.001), worse daytime functioning ( = -2.347, = 0.019), and an even higher prevalence of increased nocturia ( = 4.447, = 0.035), nightmares ( = 7.887, = 0.005), and pain ( = 9.604, = 0.002) than those of the nPD-PNS group. Analysis also indicated that the PSQI global score positively correlated with BMI ( = 0.216, < 0.05), H&Y stage ( = 0.223, < 0.05), UPDRS-I ( = 0.501, < 0.01), UPDRS-III ( = 0.425, < 0.01), ESS ( = -0.296, < 0.01), RBD ( = 0.227, < 0.05), RLS ( = 0.254, < 0.01), HAMA ( = 0.329, < 0.01), and HAMD ( = 0.466, < 0.01). In the final model, H&Y stage, RLS, UPDRS-III, and HAMD remained associated with the PQSI score ( ≤ 0.001, ≤ 0.001, = 0.049, ≤ 0.001, respectively).
Our data showed that PNS was common in patients with PD. H&Y stage, UPDRS-III, HAMD, and RLS were positively associated with PNS. Attention to the management of motor symptoms, RLS, and depression may be beneficial to nighttime sleep quality in patients with PD.
本研究调查帕金森病（PD）患者夜间睡眠不佳（PNS）的临床特征及其相关因素。
本研究纳入了110例PD患者（分为PD - PNS组和PD - nPNS组）和47名对照者（nPD - PNS组）。收集了人口统计学信息。根据统一帕金森病评定量表（UPDRS）和 Hoehn - Yahr（H&Y）分期量表对患者进行评估。还根据匹兹堡睡眠质量指数（PSQI）、爱泼华嗜睡量表（ESS）、快速眼动睡眠行为障碍筛查问卷（RBD - SQ）、不宁腿综合征（RLS）诊断、汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）对患者进行评估。
PD患者中PNS的患病率为55.45%（61/110）。与PD - nPNS组相比，PD - PNS组的病程往往更长，UPDRS - I和UPDRS - III评分更高，RLS患者的比例更高，HAMA和HAMD评分更高。与nPD - PNS组相比，PD - PNS组的RBD和RLS患者比例更高，HAMA和HAMD评分更高。对PSQI各成分和PSQI影响因素的分析表明，PD - PNS组的主观睡眠质量更差（ = -2.267， = 0.023），睡眠潜伏期更短（ = -2.262， = 0.024），使用的助眠药物更少（ = -4.170， ≤ 0.001），白天功能更差（ = -2.347， = 0.019），夜尿增多（ = 4.447， = 0.035）、噩梦（ = 7.887， = 0.005）和疼痛（ = 9.604， = 0.002）的患病率甚至更高。分析还表明，PSQI总分与体重指数（ = 0.216， < 0.05）、H&Y分期（ = 0.223， < 0.05）、UPDRS - I（ = 0.501， < 0.01）、UPDRS - III（ = 0.
