Kataoka Hiroshi, Isogawa Masahiro, Nanaura Hitoki, Kurakami Hiroyuki, Hasebe Miyoko, Kinugawa Kaoru, Kiriyama Takao, Izumi Tesseki, Kasahara Masato, Sugie Kazuma
Department of Neurology, Nara Medical University, Kashihara Nara, Japan.
Institute for Clinical and Translational Science, Nara Medical University Hospital, Kashihara Nara, Japan.
Sleep Med. 2025 May;129:363-368. doi: 10.1016/j.sleep.2025.03.007. Epub 2025 Mar 13.
Psychosis remains problematic in patients with Parkinson's disease and sleep disorders are frequent non-motor symptoms of PD. Few research studies have correctly assessed objective sleep architecture to determine the association between psychosis and sleep disorders. A mobile two-channel electroencephalography (EEG)/electrooculography (EOG) recording system is a self-applicable and affordable method for objectively measuring sleep at home. We studied patients with PD who were enrolled in ZEAL study of the randomized placebo-control clinical trial investigating the efficacy of zonisamide for sleep disorders to determine whether sleep disorders and psychosis are related by using the EEG/EOG recording system.
24 independent variables were evaluated and variables with a statistically significant correlation (p < 0.05) to psychosis on univariate logistic regression analyses were entered into multivariate logistic regression analysis using forced entry.
Forty-one patients with PD with no missing data, in both the potable EEG/EOG recording device and subjective clinical characteristics before the initiation of zonisamide, were analyzed. The major result was the reduced total sleep time (TST) and time spent in REM sleep, identified by univariate logistic regression analysis, in PD patients with psychosis. Multivariate logistic regression analysis identified nocturnal PD symptoms on the PDSS as a significant risk factor for psychosis (OR 1.409, 95 %CI 1.073-1.850; p = 0.014).
Our findings reveal that the nocturnal PD symptoms that affect regular home-based sleep may be associated with psychosis.
精神病在帕金森病患者中仍然是个问题，睡眠障碍是帕金森病常见的非运动症状。很少有研究正确评估客观睡眠结构以确定精神病与睡眠障碍之间的关联。移动双导联脑电图（EEG）/眼电图（EOG）记录系统是一种可自行应用且经济实惠的在家客观测量睡眠的方法。我们对参与唑尼沙胺治疗睡眠障碍疗效的随机安慰剂对照临床试验ZEAL研究的帕金森病患者进行了研究，以确定使用EEG/EOG记录系统时睡眠障碍与精神病是否相关。
评估了24个自变量，在单变量逻辑回归分析中与精神病有统计学显著相关性（p<0.05）的变量采用强制进入法纳入多变量逻辑回归分析。
对41例在开始使用唑尼沙胺之前便携式EEG/EOG记录设备及主观临床特征方面均无缺失数据的帕金森病患者进行了分析。主要结果是，单变量逻辑回归分析确定，患有精神病的帕金森病患者总睡眠时间（TST）和快速眼动睡眠时长减少。多变量逻辑回归分析确定，帕金森病睡眠量表（PDSS）上的夜间帕金森病症状是精神病的一个显著危险因素（比值比1.409，95%置信区间1.073 - 1.850；p = 0.014）。
我们的研究结果表明，影响常规居家睡眠的夜间帕金森病症状可能与精神病有关。
