title: Sleep and impulsivity in Parkinson's disease.
abstract: BACKGROUND
  Impulsive behavior and poor sleep are important non-motor features of Parkinson's disease (PD) that negatively impact the quality of life of patients and their families. Previous research suggests a higher level of sleep complaints in PD patients who demonstrate impulsive behaviors, but the nature of the sleep disturbances has yet to be comprehensively tested.
  
  
  METHODS
  Consecutive idiopathic PD patients (N = 143) completed the Minnesota Impulse Disorder Interview and a sleep questionnaire that assessed sleep efficiency, excessive daytime sleepiness, restless legs symptoms, snoring, dreams/nightmares, and nocturia. Patients were also given a Unified Parkinson's Disease Rating Scale motor examination and they completed cognitive testing.
  
  
  RESULTS
  Impulsive PD patients endorsed more sleep complaints than non-impulsive PD patients. The group difference was primarily attributable to poor sleep efficiency (e.g., greater nocturnal awakenings), p < .01, and greater daytime sleepiness, p < .01, in the impulsive PD patients. Interestingly, restless legs symptoms were also greater in the impulsive PD patients, p < .05. The results could not be explained by medications or disease severity.
  
  
  CONCLUSIONS
  Poor sleep efficiency, restless legs symptoms, and increased daytime sleepiness are associated with impulsivity in PD. Longitudinal studies are needed to determine whether sleep disturbances precede impulsivity in PD.
authors.affiliation: Department of Neurology, Emory University School of Medicine, 1841 Clifton Road NE, Atlanta, GA 30329, USA. Electronic address: mscullin521@gmail.com.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Scullin
authors.forename: Ann B
authors.initials: AB
authors.lastname: Sollinger
authors.forename: Julia
authors.initials: J
authors.lastname: Land
authors.forename: Cathy
authors.initials: C
authors.lastname: Wood-Siverio
authors.forename: Lavezza
authors.initials: L
authors.lastname: Zanders
authors.forename: Raven
authors.initials: R
authors.lastname: Lee
authors.forename: Alan
authors.initials: A
authors.lastname: Freeman
authors.forename: Felicia C
authors.initials: FC
authors.lastname: Goldstein
authors.forename: Donald L
authors.initials: DL
authors.lastname: Bliwise
authors.forename: Stewart A
authors.initials: SA
authors.lastname: Factor
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology
keywords: Excessive daytime sleepiness; Impulse control disorder; Parkinson's disease; Restless legs syndrome; Sleep