Objective: The aim of this study was 1) to explore relationship between depressive symptoms and subjective poor quality; 2) to establish the relationship between the depression symptoms and cognitive disturbances; 3) to compare subjective quality when patients experience depressive symptoms with or without dementia cognitive disturbances; 4) to investigate whether or not depressive symptoms are the main determinants subjective sleep quality of in PD patients.

Background: As one of the most common non-motor features of PD, sleep disturbance exerts a detrimental effect on health-related quality of life. The sleep disorders in PD is likely multi-factorial in etiology. Depression is the most common neuropsychiatric symptoms in PD, with an estimated prevalence of approximately 35%. Despite the previous studies reported correlations of depression with a variety of sleep measures, few examined the contribution of specific depressive domains.

Methods: A sample of 491 PD patients was collected and studied in the present study. Depression symptoms ?? were assessed using the Hamilton Rating Scale for Depression (HAMD). PD severity was assessed using Hoehn and Yahr (H&Y) staging, and motor symptoms were measured with the Unified PD Rating Scale (UPDRS) part III. The Montreal Cognitive Assessment (MOCA) was used to evaluate the global Cognitive status and PD Sleep Scale (PDSS) was used to quantify sleep quality.

Results: The most frequent depressive symptoms were helplessness (81.5%), depressed mood (57.8%), and general somatic symptoms (55.4%) for entire sample. Patients with cognitive disturbance (n=274; 55.8% of sample) presented more depressive symptoms than patients without cognitive disturbance (p=0.003). Patients suffer poorer sleep quality when patients experience NPS with cognitive disturbance. On linear regression models, the main determinants of subjective quality for the total sample were HAMD dimensions anxiety/somatization and Loss of weight, and disease severity. For patients with cognitive disturbance, the significant determinants were HAMD dimensions anxiety/somatization and Loss of weight, PD-related motor symptoms and sex. For patients without cognitive disturbance, the only significant determinants were anxiety/somatization and disease severity.

Conclusions: Depressive symptoms in PD are highly associated with and are determinants of subjective sleep quality, and are more prevalent in patients with cognitive disturbance. Detailed assessment and specific interventions aimed at depression and dementia could alleviate sleep burden.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/depressive-symptoms-effect-subjective-sleep-quality-in-parkinsons-disease-with-and-or-without-cognitive-disturbance/