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Sleepiness and sleepiness perception in patients with Parkinson's disease: a clinical and electrophysiological study.
Sleep. 2019 04 01; 42(4)S

Abstract

STUDY OBJECTIVES

The main objective of the study was to assess the prevalence, the severity, and the daytime course of excessive daytime sleepiness (EDS) in advanced Parkinson's disease (PD) and to explore how people with PD perceive the degree and onset of their sleepiness during objective sleepiness tests. In addition, the occurrence of early-onset rapid eye movement (REM) periods (sleep-onset REM periods [SOREMPs]) in PD was assessed.

METHODS

We analyzed data from 46 people with PD (26 males, mean age 63.5 years, mean UPDRS-III-OFF 34.7). The sleep-wake assessment included Epworth sleepiness scale (ESS), Karolinska sleepiness scale (KSS), and objective (polysomnography, multiple sleep latency test [MSLT], and maintenance of wakefulness tests [MWT]) measures.

RESULTS

Subjective (ESS ≥ 10) and objective (mean sleep latency, MSL < 5 min in MSLT) EDS were present in 43% and 41% of patients, respectively. The MSL in MSLT and MWT remained unchanged throughout the day and significantly correlated with KSS during the trial but not with KSS shortly before it. In MWT, about one-fourth of patients failed to signal their sleepiness before falling asleep. SOREMPs, usually (83%) arising from NREM1 or wake, were recorded in 24% of the patients. People with SOREMPs had significantly lower MSL in MSLT and MWT and higher AHI compared with those without SOREMPs.

CONCLUSIONS

Patients with PD exhibit daylong increased EDS but they underestimate its degree and often fail to signal its onset. SOREMPs in PD have a "narcoleptic" character in sleep-stage sequencing and are associated with the presence of sleep-disturbed breathing. These results add to our understanding of sleepiness and sleepiness perception in PD and have important implications for its diagnosis and management.

Authors+Show Affiliations

Department of Neurology, Sleep-Wake-Epilepsy Center, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.Department of Neurology, Movement Disorders Center, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.Department of Neurology, Sleep-Wake-Epilepsy Center, University Hospital (Inselspital) and University of Bern, Bern, Switzerland. Graduate School for Health Sciences, University of Bern, Bern, Switzerland.Department of Neurology, Sleep-Wake-Epilepsy Center, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.Department of Neurology, Sleep-Wake-Epilepsy Center, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30649557

Citation

Bargiotas, Panagiotis, et al. "Sleepiness and Sleepiness Perception in Patients With Parkinson's Disease: a Clinical and Electrophysiological Study." Sleep, vol. 42, no. 4, 2019.
Bargiotas P, Lachenmayer ML, Schreier DR, et al. Sleepiness and sleepiness perception in patients with Parkinson's disease: a clinical and electrophysiological study. Sleep. 2019;42(4).
Bargiotas, P., Lachenmayer, M. L., Schreier, D. R., Mathis, J., & Bassetti, C. L. (2019). Sleepiness and sleepiness perception in patients with Parkinson's disease: a clinical and electrophysiological study. Sleep, 42(4). https://doi.org/10.1093/sleep/zsz004
Bargiotas P, et al. Sleepiness and Sleepiness Perception in Patients With Parkinson's Disease: a Clinical and Electrophysiological Study. Sleep. 2019 04 1;42(4) PubMed PMID: 30649557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sleepiness and sleepiness perception in patients with Parkinson's disease: a clinical and electrophysiological study. AU - Bargiotas,Panagiotis, AU - Lachenmayer,M Lenard, AU - Schreier,David R, AU - Mathis,Johannes, AU - Bassetti,Claudio L, PY - 2018/09/30/received PY - 2018/11/21/revised PY - 2019/1/17/pubmed PY - 2020/4/15/medline PY - 2019/1/17/entrez KW - Parkinson’s disease KW - perception KW - sleep-onset REM (SOREM) KW - sleep-stage sequencing KW - sleepiness JF - Sleep JO - Sleep VL - 42 IS - 4 N2 - STUDY OBJECTIVES: The main objective of the study was to assess the prevalence, the severity, and the daytime course of excessive daytime sleepiness (EDS) in advanced Parkinson's disease (PD) and to explore how people with PD perceive the degree and onset of their sleepiness during objective sleepiness tests. In addition, the occurrence of early-onset rapid eye movement (REM) periods (sleep-onset REM periods [SOREMPs]) in PD was assessed. METHODS: We analyzed data from 46 people with PD (26 males, mean age 63.5 years, mean UPDRS-III-OFF 34.7). The sleep-wake assessment included Epworth sleepiness scale (ESS), Karolinska sleepiness scale (KSS), and objective (polysomnography, multiple sleep latency test [MSLT], and maintenance of wakefulness tests [MWT]) measures. RESULTS: Subjective (ESS ≥ 10) and objective (mean sleep latency, MSL < 5 min in MSLT) EDS were present in 43% and 41% of patients, respectively. The MSL in MSLT and MWT remained unchanged throughout the day and significantly correlated with KSS during the trial but not with KSS shortly before it. In MWT, about one-fourth of patients failed to signal their sleepiness before falling asleep. SOREMPs, usually (83%) arising from NREM1 or wake, were recorded in 24% of the patients. People with SOREMPs had significantly lower MSL in MSLT and MWT and higher AHI compared with those without SOREMPs. CONCLUSIONS: Patients with PD exhibit daylong increased EDS but they underestimate its degree and often fail to signal its onset. SOREMPs in PD have a "narcoleptic" character in sleep-stage sequencing and are associated with the presence of sleep-disturbed breathing. These results add to our understanding of sleepiness and sleepiness perception in PD and have important implications for its diagnosis and management. SN - 1550-9109 UR - https://www.unboundmedicine.com/medline/citation/30649557/Sleepiness_and_sleepiness_perception_in_patients_with_Parkinson's_disease:_a_clinical_and_electrophysiological_study_ L2 - https://academic.oup.com/sleep/article-lookup/doi/10.1093/sleep/zsz004 DB - PRIME DP - Unbound Medicine ER -