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阻塞性睡眠呼吸暂停、周期性肢体运动以及快速眼动睡眠无张力在帕金森病中很常见,且与运动症状负担相关。

Obstructive sleep apnea, periodic limb movements, and REM sleep without atonia are common in Parkinson's disease and correlate with motor symptom burden.

作者信息

Carpi Matteo, Pierantozzi Mariangela, Fernandes Mariana, Manfredi Natalia, Ludovisi Raffaella, Menegotti Michela, Schirinzi Tommaso, Cerroni Rocco, Stefani Alessandro, Mercuri Nicola Biagio, Liguori Claudio

机构信息

Sleep Medicine Centre, Neurology Unit, University Hospital Tor Vergata, Rome, Italy.

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

出版信息

J Parkinsons Dis. 2025 Sep 22:1877718X251358279. doi: 10.1177/1877718X251358279.

Abstract

BackgroundSleep disturbances are prevalent and debilitating non-motor symptoms in patients with Parkinson's disease (PD).ObjectiveThis study aimed to explore sleep architecture and the prevalence of polysomnographic (PSG) sleep findings in PD, examining the associations between sleep parameters and other clinical characteristics.MethodsThe study included 97 PD patients (age: 67.1 ± 7.9) and 42 non-PD controls (age: 64.7 ± 9.7). Participants underwent clinical assessment and video-PSG. Sleep parameters, apnea-hypopnea index (AHI), periodic limb movements index (PLMI), and REM sleep without atonia (RSWA) were obtained. General linear models were used to explore interactions between disease duration and sleep variables in predicting PD symptoms.ResultsNearly 94% of PD patients showed at least one video-PSG-assessed sleep finding, including AHI-defined obstructive sleep apnea (OSA), periodic limb movements, and RSWA. Sleep alterations correlated with disease severity, with reduced sleep duration and efficiency, higher sleep latency, and higher AHI being associated with worse PD severity. Sleep efficiency was more strongly associated with motor symptoms and disease severity at longer disease duration, while AHI exhibited a stronger relationship with motor symptoms at shorter disease duration. Finally, PD patients showed significant alterations in sleep macrostructure compared to controls, including reduced sleep duration ( = 0.75) and efficiency ( = 1.15) and decreased percentage of stage 3 non-REM sleep ( = 0.37).ConclusionsThe study showed a high prevalence of video-PSG-defined sleep findings in PD, with interactions between disease duration, sleep efficiency, and AHI. The present results support personalized management of sleep disturbances in PD to potentially improve symptoms and reduce the burden of illness.

摘要

背景

睡眠障碍是帕金森病(PD)患者中普遍存在且使人衰弱的非运动症状。

目的

本研究旨在探讨PD患者的睡眠结构以及多导睡眠图(PSG)睡眠结果的患病率,研究睡眠参数与其他临床特征之间的关联。

方法

该研究纳入了97名PD患者(年龄:67.1±7.9)和42名非PD对照者(年龄:64.7±9.7)。参与者接受了临床评估和视频PSG检查。获取了睡眠参数、呼吸暂停低通气指数(AHI)、周期性肢体运动指数(PLMI)以及无张力快速眼动睡眠(RSWA)。使用一般线性模型来探讨疾病持续时间与睡眠变量在预测PD症状方面的相互作用。

结果

近94%的PD患者至少有一项经视频PSG评估的睡眠结果,包括AHI定义的阻塞性睡眠呼吸暂停(OSA)、周期性肢体运动和RSWA。睡眠改变与疾病严重程度相关,睡眠时间和效率降低、睡眠潜伏期延长以及AHI升高与更严重的PD严重程度相关。在疾病持续时间较长时,睡眠效率与运动症状和疾病严重程度的关联更强,而在疾病持续时间较短时,AHI与运动症状的关系更强。最后,与对照组相比,PD患者的睡眠宏观结构有显著改变,包括睡眠时间缩短(=0.75)和效率降低(=1.15)以及3期非快速眼动睡眠百分比降低(=0.37)。

结论

该研究表明PD患者中经视频PSG定义的睡眠结果患病率很高,疾病持续时间、睡眠效率和AHI之间存在相互作用。目前的结果支持对PD患者的睡眠障碍进行个性化管理,以潜在地改善症状并减轻疾病负担。

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