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Dissociations among daytime sleepiness, nighttime sleep, and cognitive status in Parkinson's disease.
Parkinsonism Relat Disord. 2013 Sep; 19(9):806-11.PR

Abstract

BACKGROUND

Daytime and nighttime sleep disturbances and cognitive impairment occur frequently in Parkinson's disease (PD), but little is known about the interdependence of these non-motor complications. Thus, we examined the relationships among excessive daytime sleepiness, nighttime sleep quality and cognitive impairment in PD, including severity and specific cognitive deficits.

METHODS

Ninety-three PD patients underwent clinical and neuropsychological evaluations including the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Patients were classified as having normal cognition (PD-NC), mild cognitive impairment (PD-MCI), or dementia (PDD) using recently proposed Movement Disorder Society PD-MCI and PDD criteria. Relationships between the sleep and cognitive measures and PD cognitive groups were examined.

RESULTS

The PD cohort included PD-NC (n = 28), PD-MCI (n = 40), and PDD (n = 25) patients. ESS scores, as a measure of daytime sleepiness, were significantly worse (p = 0.005) in cognitively impaired PD patients, particularly PDD patients. ESS scores correlated significantly with Mini-Mental State Examination scores and also with cognitive domain scores for attention/working memory, executive function, memory, and visuospatial function. In contrast, PSQI scores, as a measure of nighttime sleep quality, neither differed among cognitive groups nor correlated with any cognitive measures.

CONCLUSIONS

Daytime sleepiness in PD, but not nighttime sleep problems, is associated with cognitive impairment in PD, especially in the setting of dementia, and attention/working memory, executive function, memory, and visuospatial deficits. The presence of nighttime sleep problems is pervasive across the PD cognitive spectrum, from normal cognition to dementia, and is not independently associated with cognitive impairment or deficits in cognitive domains.

Authors+Show Affiliations

Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA. Jennifer_G_Goldman@rush.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23735187

Citation

Goldman, Jennifer G., et al. "Dissociations Among Daytime Sleepiness, Nighttime Sleep, and Cognitive Status in Parkinson's Disease." Parkinsonism & Related Disorders, vol. 19, no. 9, 2013, pp. 806-11.
Goldman JG, Ghode RA, Ouyang B, et al. Dissociations among daytime sleepiness, nighttime sleep, and cognitive status in Parkinson's disease. Parkinsonism Relat Disord. 2013;19(9):806-11.
Goldman, J. G., Ghode, R. A., Ouyang, B., Bernard, B., Goetz, C. G., & Stebbins, G. T. (2013). Dissociations among daytime sleepiness, nighttime sleep, and cognitive status in Parkinson's disease. Parkinsonism & Related Disorders, 19(9), 806-11. https://doi.org/10.1016/j.parkreldis.2013.05.006
Goldman JG, et al. Dissociations Among Daytime Sleepiness, Nighttime Sleep, and Cognitive Status in Parkinson's Disease. Parkinsonism Relat Disord. 2013;19(9):806-11. PubMed PMID: 23735187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dissociations among daytime sleepiness, nighttime sleep, and cognitive status in Parkinson's disease. AU - Goldman,Jennifer G, AU - Ghode,Reena A, AU - Ouyang,Bichun, AU - Bernard,Bryan, AU - Goetz,Christopher G, AU - Stebbins,Glenn T, Y1 - 2013/06/02/ PY - 2013/03/13/received PY - 2013/05/02/revised PY - 2013/05/09/accepted PY - 2013/6/6/entrez PY - 2013/6/6/pubmed PY - 2014/3/22/medline KW - Dementia KW - Excessive daytime sleepiness KW - Executive function KW - MCI (mild cognitive impairment) KW - Parkinson's disease KW - Sleep disorders SP - 806 EP - 11 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 19 IS - 9 N2 - BACKGROUND: Daytime and nighttime sleep disturbances and cognitive impairment occur frequently in Parkinson's disease (PD), but little is known about the interdependence of these non-motor complications. Thus, we examined the relationships among excessive daytime sleepiness, nighttime sleep quality and cognitive impairment in PD, including severity and specific cognitive deficits. METHODS: Ninety-three PD patients underwent clinical and neuropsychological evaluations including the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Patients were classified as having normal cognition (PD-NC), mild cognitive impairment (PD-MCI), or dementia (PDD) using recently proposed Movement Disorder Society PD-MCI and PDD criteria. Relationships between the sleep and cognitive measures and PD cognitive groups were examined. RESULTS: The PD cohort included PD-NC (n = 28), PD-MCI (n = 40), and PDD (n = 25) patients. ESS scores, as a measure of daytime sleepiness, were significantly worse (p = 0.005) in cognitively impaired PD patients, particularly PDD patients. ESS scores correlated significantly with Mini-Mental State Examination scores and also with cognitive domain scores for attention/working memory, executive function, memory, and visuospatial function. In contrast, PSQI scores, as a measure of nighttime sleep quality, neither differed among cognitive groups nor correlated with any cognitive measures. CONCLUSIONS: Daytime sleepiness in PD, but not nighttime sleep problems, is associated with cognitive impairment in PD, especially in the setting of dementia, and attention/working memory, executive function, memory, and visuospatial deficits. The presence of nighttime sleep problems is pervasive across the PD cognitive spectrum, from normal cognition to dementia, and is not independently associated with cognitive impairment or deficits in cognitive domains. SN - 1873-5126 UR - https://www.unboundmedicine.com/medline/citation/23735187/Dissociations_among_daytime_sleepiness_nighttime_sleep_and_cognitive_status_in_Parkinson's_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(13)00193-4 DB - PRIME DP - Unbound Medicine ER -