title: Daytime sleepiness and nighttime sleep quality across the full spectrum of cognitive presentations in essential tremor.
abstract: There is increasing evidence that essential tremor (ET) is a complex and heterogeneous disorder with nonmotor features including cognitive deficits and sleep problems. We are unaware of a study that has examined sleep deficits in ET across the full spectrum of cognitive presentations. Cross-sectional (baseline) data on self-reported nighttime sleep dysfunction and excessive daytime sleepiness were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) in 96 ET cases enrolled in a prospective study. Cases underwent a comprehensive neuropsychological assessment, and were classified as ET with normal cognition (ET-NC), ET with mild cognitive impairment (ET-MCI), and ET with dementia (ET-D). PSQI scores did not significantly differ across the three ET cognitive groups (p=0.22). ESS scores were highest (more daytime sleepiness) in the ET-MCI group, followed by the ET-D and ET-NC groups, respectively (p=0.016). We examined sleep dysfunction across the cognitive spectrum in ET. We demonstrate for the first time that excessive daytime sleepiness is greater in ET-MCI than ET-NC. Unpredicted low ESS scores in the dementia group raises two possibilities: a self-report bias related to cognitive impairment and/or the possibility that currently undefined pathological heterogeneity in ET may map onto multiple presentations of non-motor deficits.
authors.affiliation: Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, 15 York Street, New Haven, CT 06510, USA.
authors.forename: Brittany
authors.initials: B
authors.lastname: Rohl
authors.affiliation: Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, 15 York Street, New Haven, CT 06510, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Collins
authors.affiliation: Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, 15 York Street, New Haven, CT 06510, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Morgan
authors.affiliation: Department of Neurology, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, New York, NY 10032,USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, New York, NY 10032, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cosentino
authors.affiliation: Department of Neurology, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, New York, NY 10032,USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, New York, NY 10032, USA; Division of Geriatric Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, New York Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Huey
authors.affiliation: Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, 15 York Street, New Haven, CT 06510, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, 333 Cedar Street, New Haven, CT 06510, USA; Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA. Electronic address: elan.louis@yale.edu.
authors.forename: Elan D
authors.initials: ED
authors.lastname: Louis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications / Q000503:physiopathology; D020329:Essential Tremor / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D006896:Hydroxyethylrutoside; D008297:Male; D009483:Neuropsychological Tests; D057566:Self Report; D012890:Sleep; D012893:Sleep Wake Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology
chemical_list: D006896:Hydroxyethylrutoside
keywords: Clinical; Cognition; Dementia; Essential tremor; Sleep