CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain.
J Geriatr Psychiatry Neurol. 2021 Nov;34(6):642-658. doi: 10.1177/0891988720964250. Epub 2020 Oct 12.
The aim of the present study was to examine the frequency of self-reported sleep problems and their associated factors in a large cohort of PD patients.
PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort were included in this cross-sectional study. Sleep problems were assessed by the Spanish version of the Parkinson's disease Sleep Scale version 1 (PDSS-1). An overall score below 82 or a score below 5 on at least 1 item was defined as sleep problems.
The frequency of sleep problems was nearly double in PD patients compared to controls: 65.8% (448/681) vs 33.5% (65/206) (p < 0.0001). Mean total PDSS score was lower in PD patients than controls: 114.9 ± 28.8 vs 132.8 ± 16.3 (p < 0.0001). Quality of life (QoL) was worse in PD patients with sleep problems compared to those without: PDQ-39SI, 19.3 ± 14 vs 13 ± 11.6 (p < 0.0001); EUROHIS-QoL8, 3.7 ± 0.5 vs 3.9 ± 0.5 (p < 0.0001). Non-motor symptoms burden (NMSS; OR = 1.029; 95%CI 1.015-1.043; p < 0.0001) and impulse control behaviors (QUIP-RS; OR = 1.054; 95%CI 1.009-1.101; p = 0.018) were associated with sleep problems after adjustment for age, gender, disease duration, daily equivalent levodopa dose, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments.
Sleep problems were frequent in PD patients and were related to both a worse QoL and a greater non-motor symptoms burden in PD. These findings call for increased awareness of sleep problems in PD patients.
本研究旨在调查大规模帕金森病（PD）患者群体中报告的睡眠问题及其相关因素的频率。
本横断面研究纳入了来自西班牙 35 个中心的 COPPADIS 队列中的 PD 患者和对照组。使用西班牙语版帕金森病睡眠量表第 1 版（PDSS-1）评估睡眠问题。总评分低于 82 分或至少 1 项评分低于 5 分被定义为存在睡眠问题。
与对照组相比，PD 患者的睡眠问题发生率几乎翻了一番：65.8%（448/681）vs 33.5%（65/206）（p<0.0001）。PD 患者的平均 PDSS 总分低于对照组：114.9±28.8 分 vs 132.8±16.3 分（p<0.0001）。与无睡眠问题的 PD 患者相比，有睡眠问题的 PD 患者的生活质量（QoL）更差：PDQ-39SI，19.3±14 分 vs 13±11.6 分（p<0.0001）；EUROHIS-QoL8，3.7±0.5 分 vs 3.9±0.5 分（p<0.0001）。非运动症状负担（NMSS；OR=1.029；95%CI 1.015-1.043；p<0.0001）和冲动控制行为（QUIP-RS；OR=1.054；95%CI 1.009-1.101；p=0.018）在调整年龄、性别、疾病持续时间、每日等效左旋多巴剂量、H&Y、UPDRS-III、UPDRS-IV、PD-CRS、BDI-II、NPI、VAS-Pain、VAFS、FOGQ 和非抗帕金森病治疗总数后与睡眠问题相关。
PD 患者中睡眠问题较为常见，与 PD 患者的 QoL 更差和非运动症状负担更大有关。这些发现呼吁提高对 PD 患者睡眠问题的认识。
