Session Information
Date: Monday, June 20, 2016
Session Title: Parkinson's disease: Non-motor symptoms
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To study sleep disturbances in Parkinson’s disease (PD) in a prospective population-based cohort.
Background: Sleep disturbances such as daytime sleepiness are frequent in PD. However, it is uncertain how persistent these symptoms are and whether they predate motor onset or may mark disease progression.
Methods: We examined 564 subjects at baseline and defined three diagnostic groups: D1) PD patients, D2) subjects at-risk for PD, defined as mild motor symptoms, enlarged hyperechogenicity of the substantia nigra upon transcranial sonography, and/or hyposmia, D3) controls. After three years, a postal follow-up was conducted with 253 subjects. As screening tools for sleep disturbances we used the Epworth Sleepiness Scale (ESS) and the Parkinson’s disease Sleep Scale (PDSS-2) at baseline and in (still ongoing) follow-ups after three years.
Results: At baseline we examined 299 men and 265 women, mean age 65±8 years. At follow-up 126 men and 127 women responded. PD patients scored highest in the PDSS-2 Score at baseline (17.8±11.4). Upon follow-up, PD patients (16.0±9.8) scored slightly higher than subjects of the at-risk group (15.3 ±11.1) (see Table 1). There was a strong correlation between PDSS-2 and ESS total scores from baseline and follow-up (r=0.706;p<0.001 and r=0.618;p<0.001). Daytime sleepiness (ESS-score>9) was most commonly present in PD patients (56% at baseline and 67% upon follow-up) and was shown to be persistent in 44% of PD patients over time, whereas only a minority (15%) of subjects at-risk for PD showed persistent daytime sleepiness (see Table 2).
| PDSS-2 Baseline | PDSS-2 Follow-up | ESS Baseline | ESS Follow-up | ||
|---|---|---|---|---|---|
| Controls | Mean ± SD | 14.3 ± 10.1 | 11.8 ± 7.9 | 6.9 ± 3.9 | 6.5 ± 3.8 |
| (n) | (n=236) | (n=128) | (n=236) | (n=128) | |
| At-risk for PD | Mean ± SD | 15.2 ± 10.4 | 15.3 ± 11.1 | 6.6 ± 3.5 | 7.0 ± 4.1 |
| (n) | (n=181) | (n=89) | (n=181) | (n=89) | |
| PD patients | Mean ± SD | 17.8 ± 11.4 | 16.0 ± 9.8 | 9.2 ± 4.3 | 10.4 ± 5.0 |
| (n) | (n=86) | (n=18) | (n=86) | (n=18) | |
| Total | Mean ± SD | 15.3 ± 10.5 | 13.7 ± 9.3 | 7.2 ± 4.0 | 7.0 ± 4.1 |
| (n) | (n=503) | (n=235) | (n=503) | (n=235) |
| ESS >9 at baseline | ESS >9 at follow-up | ESS progression: none | ESS progression: transient | ESS progression: new-onset | ESS progression: persistent | |
|---|---|---|---|---|---|---|
| Controls | 26.8% | 26.0% | 61.8% | 12.2% | 11.4% | 14.6% |
| At-risk for PD | 29.9% | 29.9% | 55.2% | 14.9% | 14.9% | 14.9% |
| PD patients | 55.6% | 66.7% | 22.2% | 11.1% | 22.2% | 44.4% |
Conclusions: Sleep quality was poorest in PD patients at baseline and was shown to be persistent over time. The prevalence of relevant daytime sleepiness in PD was almost twice as high as in the other groups and progressive over time. Interestingly, only a minority of subjects at-risk for PD was affected by persistent daytime sleepiness, which may indicate worsening of daytime sleepiness with disease progression.
To cite this abstract in AMA style:
S. Tunc, J. Hampf, E.J. Vollstedt, K. Hückelheim, E. Warrlich, C. Kritzinger, C. Bibergeil, J. Graf, C. Klein, M. Kasten. Characterization of sleep disturbances in a prospective population-based cohort to investigate Parkinson’s disease [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/characterization-of-sleep-disturbances-in-a-prospective-population-based-cohort-to-investigate-parkinsons-disease/. Accessed June 15, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/characterization-of-sleep-disturbances-in-a-prospective-population-based-cohort-to-investigate-parkinsons-disease/