title: Comparison of sleep disturbance in mild versus severe Parkinson's disease.
abstract: OBJECTIVE
  To determine the effect of mild vs severe Parkinson's disease on objective sleep parameters, in a subgroup of patients with subjective excessive daytime somnolence.
  
  
  METHODS
  Patients with either mild (Hoehn and Yahr stage 1 or 2) or severe (Hoehn and Yahr stage 4 or 5) idiopathic Parkinson's disease and subjective evidence of sleepiness (Epworth sleepiness scale > 8) were recruited. All patients underwent overnight polysomnography autonomic function testing and completed questionnaires assessing quality of life, mood, and drug dosages. Mild and severe groups were then compared using the paired t-test for normally distributed data and the Mann-Whitney U test for nonparametric data.
  
  
  METHODS
  Accredited sleep centre and neurosciences unit at tertiary referral centre.
  
  
  METHODS
  Parkinson's disease outpatients referred by their treating neurologist.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  11 patients with mild disease and 7 with severe disease were studied. Both groups slept poorly when compared to historic normal controls. Their sleep efficiency was decreased, and the architecture fragmented. However, there was no significant difference in objective sleep parameters between the two groups. There was a significant increase in the number of voids overnight in the severe disease group (p< 0.05).
  
  
  CONCLUSIONS
  In this subgroup of patients with subjective excessive day-time somnolence, the severity of Parkinson's disease was not associated with a change in the measured sleep parameters. Other factors, such as drug effects, may have played a greater role. Alternatively, motor/functional measures of disease severity may poorly reflect the level of sleep disturbance. Nocturia is an important factor which disturbs sleep, particularly in the severe disease group.
authors.affiliation: alancyoung@bigpond.com
authors.forename: Alan
authors.initials: A
authors.lastname: Young
authors.forename: Malcolm
authors.initials: M
authors.lastname: Home
authors.forename: Tom
authors.initials: T
authors.lastname: Churchward
authors.forename: Nicholas
authors.initials: N
authors.lastname: Freezer
authors.forename: Peter
authors.initials: P
authors.lastname: Holmes
authors.forename: Michael
authors.initials: M
authors.lastname: Ho
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000453:epidemiology*; D017286:Polysomnography; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D012895:Sleep, REM / Q000502:physiology; D011795:Surveys and Questionnaires