Effects of sleep disorders on the non-motor symptoms of Parkinson disease.
OBJECTIVE
To evaluate the impact of sleep disorders on non-motor symptoms in patients with Parkinson disease (PD).


METHODS
This was a cross-sectional study. Patients with PD were evaluated for obstructive sleep apnea (OSA), restless legs syndrome (RLS), periodic limb movement syndrome (PLMS), and REM sleep behavior disorder (RBD). Cognition was assessed with the Montreal Cognitive Assessment and patients completed self-reported questionnaires assessing non-motor symptoms including depressive symptoms, fatigue, sleep complaints, daytime sleepiness, and quality of life.


METHODS
Sleep laboratory.


METHODS
86 patients with PD (mean age = 67.4 ± 8.8 years; range: 47-89; 29 women).


METHODS
N/A.


RESULTS
Having sleep disorders was a predictor of overall non-motor symptoms in PD (R(2) = 0.33, p < 0.001) while controlling for age, PD severity, and dopaminergic therapy. These analyses revealed that RBD (p = 0.006) and RLS (p = 0.014) were significant predictors of increased non-motor symptoms, but OSA was not. More specifically, having a sleep disorder significantly predicted sleep complaints (ΔR(2) = 0.13, p = 0.006), depressive symptoms (ΔR(2) = 0.01, p = 0.03), fatigue (ΔR(2) = 0.12, p = 0.007), poor quality of life (ΔR(2) = 0.13, p = 0.002), and cognitive decline (ΔR(2) = 0.09, p = 0.036). Additionally, increasing number of sleep disorders (0, 1, or ≥ 2 sleep disorders) was a significant contributor to non-motor symptom impairment (R(2) = 0.28, p < 0.001).


CONCLUSIONS
In this study of PD patients, presence of comorbid sleep disorders predicted more non-motor symptoms including increased sleep complaints, more depressive symptoms, lower quality of life, poorer cognition, and more fatigue. RBD and RLS were factors of overall increased non-motor symptoms, but OSA was not.
SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA ; Veterans Medical Research Foundation, San Diego, CA.
Ariel B
AB
Neikrug
Jeanne E
JE
Maglione
Lianqi
L
Liu
Loki
L
Natarajan
Julie A
JA
Avanzino
Jody
J
Corey-Bloom
Barton W
BW
Palmer
Jose S
JS
Loredo
Sonia
S
Ancoli-Israel
D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D003072:Cognition Disorders / Q000453:epidemiology* / Q000503:physiopathology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000503:physiopathology; D005221:Fatigue / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D020189:Nocturnal Myoclonus Syndrome; D010300:Parkinson Disease / Q000453:epidemiology* / Q000503:physiopathology*; D011788:Quality of Life; D020187:REM Sleep Behavior Disorder / Q000453:epidemiology / Q000503:physiopathology; D012148:Restless Legs Syndrome / Q000453:epidemiology / Q000503:physiopathology; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000503:physiopathology; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000503:physiopathology*; D011795:Surveys and Questionnaires
Parkinson disease; non-motor symptoms; quality of life; sleep disorders