Shen Yuan, Shi Haicun, Zhong JianGuo, Pan PingLei, Wang ShuFang, Chen MingZhu, Chen ZhiPeng, Liu ChunFeng
Department of Neurology, The Yancheng School of Clinical Medicine of Nanjing Medical University, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China.
Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Brain Behav. 2023 Oct;13(10):e3202. doi: 10.1002/brb3.3202. Epub 2023 Aug 2.
To explore the factors correlated with excessive daytime sleepiness (EDS) in patients with Parkinson's disease (PD).
A total of 239 PD patients were divided into two groups based on the presence of EDS (Epworth Sleepiness Scale score≥10) (PD-EDS vs. PD-non-EDS). Participants underwent an extensive assessment to determine demographic features, disease severity, polysomnography characteristics, and nonmotor symptoms.
Of the 239 patients, 56 patients (23.4%) were classified as having PD combined with EDS. Binary logistic regression analysis showed that fatigue (Fatigue Severity Scale [FSS] score ≥4) (odds ratio [OR] [95% CI] = 4.897 [2.376-10.095], p < .001) and the respiratory-related microarousal index (OR [95% CI] = 2.063 [1.085-3.923], p = .027) were independent risk factors for EDS in PD patients. A priori-determined stratified analysis showed that after adjustment for confounding factors, the association of the respiratory-related microarousal index with EDS was significant (OR = 4.404, 95% CI 1.673-11.592, p trend = .036) in patients with respiratory arousal index scores in the highest quintile compared with those with scores in the lowest quintile.
Our data revealed a close association among the respiratory-related microarousal index, FSS scores, and EDS. It can be speculated that fragmented sleep and pathological abnormalities of the central nervous system resulting in changes in arousal are major influencing factors of EDS in PD.
探讨帕金森病（PD）患者日间过度嗜睡（EDS）的相关因素。
根据Epworth嗜睡量表评分≥10，将239例PD患者分为两组（PD-EDS组与PD-无EDS组）。参与者接受了广泛评估，以确定人口统计学特征、疾病严重程度、多导睡眠图特征和非运动症状。
239例患者中，56例（23.4%）被归类为患有PD合并EDS。二元逻辑回归分析显示，疲劳（疲劳严重程度量表[FSS]评分≥4）（比值比[OR][95%置信区间]=4.897[2.376-10.095]，p<.001）和呼吸相关微觉醒指数（OR[95%置信区间]=2.063[1.085-3.923]，p=.027）是PD患者EDS的独立危险因素。预先确定的分层分析显示，在调整混杂因素后，呼吸相关微觉醒指数与EDS的关联在呼吸觉醒指数评分处于最高五分位数的患者中与处于最低五分位数的患者相比具有显著性（OR=4.404，95%置信区间1.673-11.592，p趋势=.036）。
我们的数据揭示了呼吸相关微觉醒指数、FSS评分和EDS之间的密切关联。可以推测，睡眠片段化和中枢神经系统的病理异常导致觉醒变化是PD患者EDS的主要影响因素。
