title: Subjective sleep dysfunction and insomnia symptoms in Parkinson's disease: Insights from a cross-sectional evaluation of the French CoPark cohort.
abstract: BACKGROUND
  Twenty-seven to 80% of patients with Parkinson's Disease (PD) complain of subjective sleep dysfunction and insomnia symptoms. Our aim is to describe the prevalence and features of subjective sleep dysfunction and insomnia symptoms in patients with PD compared to other patients.
  
  
  METHODS
  Cross-sectional analysis of 636 adult PD patients compared to 143 age and sex-matched non-PD control patients consulting their general practitioners. Insomnia symptoms and other sleep features were assessed by the Pittsburgh Sleep Quality Index (PSQI), a global score > 5 defining impaired sleep. The Chi-square test or the Student's t-test were used to assess the potential clinical and demographic differences between groups and between PD patients with vs. without sleep dysfunction. Logistic regression analysis was employed to test multivariate effects.
  
  
  RESULTS
  Sleep dysfunction and insomnia symptoms were more frequent in PD patients compared to control patients (63 vs. 45%, p = 0.001). Female gender, PD duration, presence of depression and anxiety were associated with the presence of insomnia in PD. Subjective sleep efficiency, habitual sleep quality, sleep disturbance and daytime dysfunction, but not sleep latency, were reduced in PD patients compared to controls.
  
  
  CONCLUSIONS
  The prevalence of sleep dysfunction is higher in PD than in other general medical conditions. Insomnia in PD seems to affect sleep maintenance and consolidation, but not sleep onset.
authors.affiliation: Department of Clinical Pharmacology, Paul Sabatier University and Toulouse University Hospital, Toulouse, France; INSERM UMR825 Neuroimaging and Neurologic Diseases, Toulouse, France; Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital (EOC) of Lugano, Switzerland. Electronic address: pietroluca.ratti@eoc.ch.
authors.forename: Pietro-Luca
authors.initials: PL
authors.lastname: Ratti
authors.affiliation: Department of Clinical Pharmacology, Paul Sabatier University and Toulouse University Hospital, Toulouse, France; LN-Pharma, Toulouse, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Nègre-Pagès
authors.affiliation: Department of Clinical Pharmacology, Paul Sabatier University and Toulouse University Hospital, Toulouse, France.
authors.forename: Santiago
authors.initials: S
authors.lastname: Pérez-Lloret
authors.affiliation: Sleep Medicine and Epilepsy Unit, IRCCS "C. Mondino National Institute of Neurology" Foundation, Pavia, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Manni
authors.affiliation: Pôle Neurosciences, Centre Hospitalier Universitaire de Nantes, Centre d'Investigation Clinique CIC 04, Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Damier
authors.affiliation: Service de Neurologie, Groupe Hospitalier Sud, Hôpital Haut-Lévèque, Centre Hospitalier Universitaire de Bordeaux, France.
authors.forename: François
authors.initials: F
authors.lastname: Tison
authors.affiliation: Service de Neurologie et pathologie du mouvement, Pôle de Neurologie, Centre Hospitalier Universitaire de Lille, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Destée
authors.affiliation: Department of Clinical Pharmacology, Paul Sabatier University and Toulouse University Hospital, Toulouse, France; INSERM UMR825 Neuroimaging and Neurologic Diseases, Toulouse, France; Centre d'Investigation Clinique CIC 9302, Toulouse University Hospital, Toulouse, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Rascol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology*; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*; D012893:Sleep Wake Disorders / Q000453:epidemiology*
keywords: Epidemiology; Insomnia; Parkinson's disease; Sleep dysfunction