Slow wave sleep and dopaminergic treatment in Parkinson's disease: a polysomnographic study.
BACKGROUND
In Parkinson's disease (PD), there is entanglement of disease-inherent and treatment-induced sleep abnormalities. So far, there has been no study specifically investigating the influence of diurnal dopaminergic medication (DM) on nocturnal slow wave sleep (SWS).


METHODS
Polysomnographic analysis in 62 PD patients.


RESULTS
PD patients had a sleep efficiency of 70 +/- 17% and an SWS amount of 16 +/- 11%. Linear regression analysis showed no significant correlation between the amounts of SWS and DM. However, patients with a medium DM dosage (300-600 mg of levodopa equivalents) preserved a SWS percentage >25% (p = 0.035, chi(2) test) more frequently than patients with higher or smaller DM. The DM dosage had no effect on other main sleep parameters. Psychotropic comedication had no effect on SWS percentage. In contrast, SWS amount was inversely correlated with both disease duration and age. It was independent of rapid eye movement sleep amount. The natural female bonus effect on SWS amount was absent in women with PD.


CONCLUSIONS
Diurnal dopaminergic treatment has no major impact on SWS in PD, which, however, decreases with disease duration. Disease-dependent, but treatment-independent decrease in SWS suggests primary degeneration of sleep-regulating systems in PD.
Diederich
N J
NJ
Department of Neurosciences, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg. diederdn@pt.lu
Paolini
V
V
Vaillant
M
M
D000368:Aged; D015259:Dopamine Agents / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology; D017286:Polysomnography; D012737:Sex Factors; D012890:Sleep / Q000187:drug effects*; D012895:Sleep, REM; D018709:Statistics, Nonparametric
D015259:Dopamine Agents