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Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease.
PLoS One. 2013; 8(11):e81233.Plos

Abstract

INTRODUCTION

Sleep-wake disturbances and concomitant cognitive dysfunction in Parkinson's disease (PD) contribute significantly to morbidity in patients and their carers. Subjectively reported daytime sleep disturbance is observed in over half of all patients with PD and has been linked to executive cognitive dysfunction. The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls. Furthermore this study aimed to identify patients with PD who may benefit from pharmacologic and behavioural intervention to improve these symptoms.

METHODS

Eighty-five PD patients and 21 healthy, age-matched controls completed 14 days of wrist actigraphy within two weeks of neuropsychological testing. Objective napping measures were derived from actigraphy using a standardised protocol and subjective daytime sleepiness was recorded by the previously validated Epworth Sleepiness Scale.

RESULTS

Patients with PD had a 225% increase in the mean nap time per day (minutes) as recorded by actigraphy compared to age matched controls (39.2 ± 35.2 vs. 11.5 ± 11.0 minutes respectively, p < 0.001). Significantly, differences in napping duration between patients, as recorded by actigraphy were not distinguished by their ratings on the subjective measurement of excessive daytime sleepiness. Finally, those patients with excessive daytime napping showed greater cognitive deficits in the domains of attention, semantic verbal fluency and processing speed.

CONCLUSION

This study confirms increased levels of napping in PD, a finding that is concordant with subjective reports. However, subjective self-report measures of excessive daytime sleepiness do not robustly identify excessive napping in PD. Fronto-subcortical cognitive dysfunction was observed in those patients who napped excessively. Furthermore, this study suggests that daytime actigraphy, a non-invasive and inexpensive objective measure of daytime sleep, can identify patients with PD who may benefit from pharmacologic and behavioural interventions to improve these symptoms.

Authors+Show Affiliations

Parkinson's Disease Clinic, Brain and Mind Research Institute, The University of Sydney, Sydney, New South Wales, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24278399

Citation

Bolitho, Samuel J., et al. "Objective Measurement of Daytime Napping, Cognitive Dysfunction and Subjective Sleepiness in Parkinson's Disease." PloS One, vol. 8, no. 11, 2013, pp. e81233.
Bolitho SJ, Naismith SL, Salahuddin P, et al. Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease. PLoS One. 2013;8(11):e81233.
Bolitho, S. J., Naismith, S. L., Salahuddin, P., Terpening, Z., Grunstein, R. R., & Lewis, S. J. (2013). Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease. PloS One, 8(11), e81233. https://doi.org/10.1371/journal.pone.0081233
Bolitho SJ, et al. Objective Measurement of Daytime Napping, Cognitive Dysfunction and Subjective Sleepiness in Parkinson's Disease. PLoS One. 2013;8(11):e81233. PubMed PMID: 24278399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease. AU - Bolitho,Samuel J, AU - Naismith,Sharon L, AU - Salahuddin,Pierre, AU - Terpening,Zoe, AU - Grunstein,Ron R, AU - Lewis,Simon J G, Y1 - 2013/11/21/ PY - 2013/04/23/received PY - 2013/10/10/accepted PY - 2013/11/27/entrez PY - 2013/11/28/pubmed PY - 2015/5/9/medline SP - e81233 EP - e81233 JF - PloS one JO - PLoS One VL - 8 IS - 11 N2 - INTRODUCTION: Sleep-wake disturbances and concomitant cognitive dysfunction in Parkinson's disease (PD) contribute significantly to morbidity in patients and their carers. Subjectively reported daytime sleep disturbance is observed in over half of all patients with PD and has been linked to executive cognitive dysfunction. The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls. Furthermore this study aimed to identify patients with PD who may benefit from pharmacologic and behavioural intervention to improve these symptoms. METHODS: Eighty-five PD patients and 21 healthy, age-matched controls completed 14 days of wrist actigraphy within two weeks of neuropsychological testing. Objective napping measures were derived from actigraphy using a standardised protocol and subjective daytime sleepiness was recorded by the previously validated Epworth Sleepiness Scale. RESULTS: Patients with PD had a 225% increase in the mean nap time per day (minutes) as recorded by actigraphy compared to age matched controls (39.2 ± 35.2 vs. 11.5 ± 11.0 minutes respectively, p < 0.001). Significantly, differences in napping duration between patients, as recorded by actigraphy were not distinguished by their ratings on the subjective measurement of excessive daytime sleepiness. Finally, those patients with excessive daytime napping showed greater cognitive deficits in the domains of attention, semantic verbal fluency and processing speed. CONCLUSION: This study confirms increased levels of napping in PD, a finding that is concordant with subjective reports. However, subjective self-report measures of excessive daytime sleepiness do not robustly identify excessive napping in PD. Fronto-subcortical cognitive dysfunction was observed in those patients who napped excessively. Furthermore, this study suggests that daytime actigraphy, a non-invasive and inexpensive objective measure of daytime sleep, can identify patients with PD who may benefit from pharmacologic and behavioural interventions to improve these symptoms. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24278399/Objective_measurement_of_daytime_napping_cognitive_dysfunction_and_subjective_sleepiness_in_Parkinson's_disease_ L2 - https://dx.plos.org/10.1371/journal.pone.0081233 DB - PRIME DP - Unbound Medicine ER -