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Nocturnal sleep disturbances and daytime dysfunction in patients with Parkinson's disease and in their caregivers.
Parkinsonism Relat Disord. 2004 Mar; 10(3):157-68.PR

Abstract

BACKGROUND

The role of aging, disease, medications, and mood disturbances in sleep disturbances (SD) in patients with Parkinson's disease (PD) is poorly understood, and the impact of SD on the quality of life of their caregivers (CG) largely undocumented.

OBJECTIVES

To evaluate the pattern and determinants of disturbed sleep in PD patients complaining of SD, and in their primary CG.

METHODS

A prospective evaluation of 40 non-demented patients with PD complaining of SD and 23 of their primary CG (all were spouses) was conducted using Pittsburgh Sleep Quality Index, Zung's self-rating depression and anxiety scales, Parkinson's Impact Scale (PIMS) (only for PD), and an additional sleep questionnaire.

RESULTS

Eighty-four percent of patients were 'poor sleepers' with global sleep scores (GLSc) > 5. Other abnormalities were: excessive daytime sleepiness-57.5%, excessive daytime fatigue-72.5%, depression-51.5%, anxiety-63.1%, and abnormal PIMS score-83.8%. There was no correlation between the degree of sleep dysfunction and the age, severity, duration of PD or its treatment. Several component sleep scores correlated with anxiety scores, PIMS score with depression, and, subjects with GLSc > or = 10 had higher mean anxiety index. Daytime dysfunction (97.5%) was mainly associated with reduced enthusiasm, rather than excessive sleepiness. Among CG, 40% had a GLSc > 5, 21% had depression, and 10.5% had anxiety. Their depression, anxiety and sleep scores correlated with those of their spouses.

CONCLUSIONS

PD patients with significant SD may represent a subset of patients with early, progressive degeneration of sleep centres, rather than an enhanced aging process. They are more susceptible mood disturbances, which correlate with the severity of sleep dysfunction. Sleep and mood disturbances also adversely affect the quality of life of spousal caregivers.

Authors+Show Affiliations

Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15036171

Citation

Pal, P K., et al. "Nocturnal Sleep Disturbances and Daytime Dysfunction in Patients With Parkinson's Disease and in Their Caregivers." Parkinsonism & Related Disorders, vol. 10, no. 3, 2004, pp. 157-68.
Pal PK, Thennarasu K, Fleming J, et al. Nocturnal sleep disturbances and daytime dysfunction in patients with Parkinson's disease and in their caregivers. Parkinsonism Relat Disord. 2004;10(3):157-68.
Pal, P. K., Thennarasu, K., Fleming, J., Schulzer, M., Brown, T., & Calne, S. M. (2004). Nocturnal sleep disturbances and daytime dysfunction in patients with Parkinson's disease and in their caregivers. Parkinsonism & Related Disorders, 10(3), 157-68.
Pal PK, et al. Nocturnal Sleep Disturbances and Daytime Dysfunction in Patients With Parkinson's Disease and in Their Caregivers. Parkinsonism Relat Disord. 2004;10(3):157-68. PubMed PMID: 15036171.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nocturnal sleep disturbances and daytime dysfunction in patients with Parkinson's disease and in their caregivers. AU - Pal,P K, AU - Thennarasu,K, AU - Fleming,J, AU - Schulzer,M, AU - Brown,T, AU - Calne,S M, PY - 2003/06/04/received PY - 2003/11/06/revised PY - 2003/11/06/accepted PY - 2004/3/24/pubmed PY - 2004/4/28/medline PY - 2004/3/24/entrez SP - 157 EP - 68 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 10 IS - 3 N2 - BACKGROUND: The role of aging, disease, medications, and mood disturbances in sleep disturbances (SD) in patients with Parkinson's disease (PD) is poorly understood, and the impact of SD on the quality of life of their caregivers (CG) largely undocumented. OBJECTIVES: To evaluate the pattern and determinants of disturbed sleep in PD patients complaining of SD, and in their primary CG. METHODS: A prospective evaluation of 40 non-demented patients with PD complaining of SD and 23 of their primary CG (all were spouses) was conducted using Pittsburgh Sleep Quality Index, Zung's self-rating depression and anxiety scales, Parkinson's Impact Scale (PIMS) (only for PD), and an additional sleep questionnaire. RESULTS: Eighty-four percent of patients were 'poor sleepers' with global sleep scores (GLSc) > 5. Other abnormalities were: excessive daytime sleepiness-57.5%, excessive daytime fatigue-72.5%, depression-51.5%, anxiety-63.1%, and abnormal PIMS score-83.8%. There was no correlation between the degree of sleep dysfunction and the age, severity, duration of PD or its treatment. Several component sleep scores correlated with anxiety scores, PIMS score with depression, and, subjects with GLSc > or = 10 had higher mean anxiety index. Daytime dysfunction (97.5%) was mainly associated with reduced enthusiasm, rather than excessive sleepiness. Among CG, 40% had a GLSc > 5, 21% had depression, and 10.5% had anxiety. Their depression, anxiety and sleep scores correlated with those of their spouses. CONCLUSIONS: PD patients with significant SD may represent a subset of patients with early, progressive degeneration of sleep centres, rather than an enhanced aging process. They are more susceptible mood disturbances, which correlate with the severity of sleep dysfunction. Sleep and mood disturbances also adversely affect the quality of life of spousal caregivers. SN - 1353-8020 UR - https://www.unboundmedicine.com/medline/citation/15036171/Nocturnal_sleep_disturbances_and_daytime_dysfunction_in_patients_with_Parkinson's_disease_and_in_their_caregivers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353802003001500 DB - PRIME DP - Unbound Medicine ER -