title: Sleep disruption in Parkinson's disease. Assessment by continuous activity monitoring.
abstract: OBJECTIVE
  To assess differences in activity and immobility during sleep between patients with Parkinson's disease (PD) and healthy subjects and to evaluate the relations of clinical variables with the motor activity measures in patients with PD.
  
  
  METHODS
  Survey, case series.
  
  
  METHODS
  University hospital outpatient neurology department and urban population in Leiden, the Netherlands. Motor activity was recorded during 6 successive nights at home with a wrist-worn activity monitor.
  
  
  METHODS
  Eighty-nine patients with PD and 83 age-matched healthy controls.
  
  
  METHODS
  For each subject, three mean measures reflecting activity or immobility during the nocturnal period were calculated.
  
  
  RESULTS
  Compared with the healthy elderly subjects, patients with PD have an elevated nocturnal activity level and an increased proportion of time with movement, indicating a more disturbed sleep. The mean duration of nocturnal immobility periods was similar for both groups. This measure, however, did reflect the self-reported disturbed sleep maintenance in both groups. The daily dose of levodopa or the use of dopamine agonists in patients not receiving levodopa, rather than disease severity, proved to be the best predictors of nocturnal activity.
  
  
  CONCLUSIONS
  We hypothesize that in mildly to moderately affected patients with PD, levodopa or dopamine agonists cause sleep disruption by their effects on sleep regulation. In more severely affected patients, the beneficial effects of these drugs on nocturnal disabilities that cause sleep disruption in PD prevail.
authors.affiliation: Department of Neurology, Academic Hospital, Leiden, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: van Hilten
authors.forename: J I
authors.initials: JI
authors.lastname: Hoff
authors.forename: H A
authors.initials: HA
authors.lastname: Middelkoop
authors.forename: E A
authors.initials: EA
authors.lastname: van der Velde
authors.forename: G A
authors.initials: GA
authors.lastname: Kerkhof
authors.forename: A
authors.initials: A
authors.lastname: Wauquier
authors.forename: H A
authors.initials: HA
authors.lastname: Kamphuisen
authors.forename: R A
authors.initials: RA
authors.lastname: Roos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009043:Motor Activity; D009068:Movement; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology*; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000503:physiopathology*
chemical_list: D000978:Antiparkinson Agents