Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To investigate baseline risk factors of insomnia symptoms after five years of follow-up, on average, in a population-based study of Parkinson’s disease (PD).
Background: Sleep problems are important and common non-motor symptoms of PD1; insomnia is one of those and is also common in the elderly in general. Insomnia is characterized by difficulty in initiating and/or maintaining and poor quality of sleep and is strongly associated with quality of life and mortality in PD2. It is significant to the quality of care in PD to study early-disease risk factors for insomnia symptoms in later phases.
Methods: This is a population-based cohort of incident PD cases assessed at three time points from 2001 to 2009 by trained interviewers and neurologists. There are only 8 population-based studies of incident PD and sleep; this is the only in the U.S and the only to have used the Medical Outcomes Sleep Scale (MOS-SS) in PD. We describe the distribution and estimate associations of baseline demographic and clinical features, per insomnia symptoms severity at last assessment, measured by the continuous score (0-100) of the Sleep Disturbance sub-scale. Bi and multivariable linear regression models were used, according to causal models proposed to explain relations of variables, instead of use of pure statistical criteria.
Results: At baseline, 360 patients were included, mean(SD) age and PD duration were: 70.4(10.2) and 2.1(1.5), 206(57.2%) were men and 321(89.2%) were using levodopa or dopamine agonist. At last follow-up, 186 completed the MOS-SS, mean(SD) disease duration and insomnia score were 7.5(2.6) and 28.4(22.4). On bivariable regressions, baseline factors significantly associated with future worse insomnia, with respective mean differences 95% CI were: lifetime average of sleep hours (-1.02,-0.39), depression score (0.14,0.32), UPDRS (0.03,0.10) and PD duration (0.0,0.46). On a multivariable model, worse baseline depression, UPDRS and longer PD duration were all significant predictors of worse insomnia symptoms later in the disease.
Conclusions: Depression and worse motor symptoms early in PD were important predictors of worse sleep after an average of 5.5 years of follow-up and could be target on interventions to improve quality of life in PD. Alternative regression models and loss to follow-up should be considered and explored in future analyses.
References: 1-Pfeiffer RF. Non-motor symptoms in Parkinson’s disease. Park Relat Disord. 2016;22:S119-S122. doi:10.1016/j.parkreldis.2015.09.004.
2-Wu Y, Guo XY, Wei QQ, et al. Determinants of the quality of life in Parkinson’s disease: Results of a cohort study from Southwest China. J Neurol Sci. 2014;340(1-2):144-149. doi:10.1016/j.jns.2014.03.014.
To cite this abstract in AMA style:A. Duarte Folle, B. Ritz, K. Paul. Baseline risk factors of insomnia symptoms after five years of follow-up: a population-based cohort of incident Parkinson’s disease [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/baseline-risk-factors-of-insomnia-symptoms-after-five-years-of-follow-up-a-population-based-cohort-of-incident-parkinsons-disease/. Accessed December 11, 2023.
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