Activity-rest rhythm abnormalities in Parkinson's disease patients are related to dopaminergic therapy.
OBJECTIVE
To compare going to bed, waking-up, and immobility onset and offset times in Parkinson's disease (PD) patients receiving levodopa and/or dopamine agonists (i.e., dopaminergic therapy or DT) with "de novo" patients and healthy controls and to correlate these parameters with self-reported sleep disturbances.


METHODS
Fifteen "de novo" and 60 PD patients on DT were included in the study. Twenty-three subjects without history of sleep complaints and similar age and sex distributions as the PD patients served as controls. Going to bed and waking-up times were registered in 7-day sleep logs. Nocturnal immobility onset and offset times were measured using actigraphy. Sleep disorders were assessed applying the PD sleep scale (PDSS).


RESULTS
Patients on DT showed earlier waking-up and immobility offset times (40 min) compared with controls and "de novo" patients. Multivariable regression analysis showed that DT but not Hoehn & Yahr score was a significant and independent predictor of early awakening time (OR = 4.0, 95% CI = 1.15-14.13). Patients manifesting more frequent nighttime psychotic symptoms and more frequent daytime somnolence showed earlier going to bed and waking-up times.


CONCLUSIONS
Results suggest that activity-rest rhythm alteration in PD may be a consequence of DT but not of disease stage. Altered sleep cycles correlated with diurnal somnolence and nocturnal psychosis.
Perez-Lloret
Santiago
S
Movement Disorders Section, Raul Carrea Institute for Neurological Research, FLENI, Buenos Aires, Argentina.
Santiago
Perez-Lloret
PL
Rossi
Malco
M
Cardinali
Daniel P
DP
Merello
Marcelo
M
D056044:Actigraphy / Q000379:methods; D000203:Activities of Daily Living; D000368:Aged; D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000187:drug effects*; D015259:Dopamine Agents / Q000009:adverse effects* / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects* / Q000494:pharmacology*; D008297:Male; D010147:Pain Measurement; D010300:Parkinson Disease / Q000188:drug therapy; D017286:Polysomnography / Q000379:methods; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000139:chemically induced* / Q000503:physiopathology; D018709:Statistics, Nonparametric; D014851:Wakefulness / Q000187:drug effects
D015259:Dopamine Agents; D007980:Levodopa