Department of Neurology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Eur Neurol. 2023;86(6):377-386. doi: 10.1159/000533905. Epub 2023 Sep 6.
Sleep disorders are common in Parkinson's disease (PD) and significantly impact quality of life. Herein, we surveyed the incidence and severity of sleep disorders in Chinese PD patients and observed their relationship with dopaminergic drugs.
We collected the demographic and disease information of 232 PD patients. The incidence and severity of sleep disorders were surveyed with the Parkinson's disease sleep scale (PDSS) Chinese version. Data on dopaminergic drug intake were collected and converted to levodopa equivalent doses (LED).
The average total score of PDSS in 232 patients was 119.3 ± 19.7. There was a significant difference in PDSS scores between groups classified by the Hoehn-Yahr (H&Y) stage, but not between the groups classified by the type of dopaminergic drugs. Stepwise regression analysis revealed that the LED of dopaminergic drugs taken before bedtime (p < 0.00), LED of dopaminergic drugs taken over a 24-h period (p < 0.00), and scores of the Hamilton Rating Scale for Depression (HAMD) (p = 0.01) were determinants of PDSS.
Sleep disorders in PD patients may be multifactorial. High dosage of dopaminergic drugs taken prior to sleep, daily total high dosage of dopaminergic drugs, and depression exert negative effects on subjective sleep. The timing and dosage of dopaminergic drugs taken before bedtime should be considered in PD management.
睡眠障碍在帕金森病(PD)中很常见,严重影响生活质量。在此,我们调查了中国 PD 患者睡眠障碍的发生率和严重程度,并观察了它们与多巴胺能药物的关系。
我们收集了 232 例 PD 患者的人口统计学和疾病信息。使用帕金森病睡眠量表(PDSS)中文版调查睡眠障碍的发生率和严重程度。收集多巴胺能药物摄入数据,并转换为左旋多巴等效剂量(LED)。
232 例患者的 PDSS 总分平均为 119.3±19.7。根据 Hoehn-Yahr(H&Y)分期分组的 PDSS 评分有显著差异,但根据多巴胺能药物类型分组的 PDSS 评分无显著差异。逐步回归分析显示,睡前服用的多巴胺能药物的 LED(p < 0.00)、24 小时内服用的多巴胺能药物的 LED(p < 0.00)和汉密尔顿抑郁量表(HAMD)评分(p = 0.01)是 PDSS 的决定因素。
PD 患者的睡眠障碍可能是多因素的。睡前服用的高剂量多巴胺能药物、每日总高剂量多巴胺能药物和抑郁对主观睡眠产生负面影响。在 PD 管理中应考虑睡前多巴胺能药物的给药时间和剂量。