Session Information
Date: Wednesday, September 25, 2019
Session Title: Non-Motor Symptoms
Session Time: 1:15pm-2:45pm
Location: Agora 3 West, Level 3
Objective: To evaluate the effects of controlled-released (CR) levodopa on quality of sleep and nocturnal movements as assessed with mobile health technology in patients with Parkinson’s Disease (PD).
Background: Sleep-maintenance insomnia and sleep fragmentation are common in PD, with up to 70% of the patients being affected. Based on the assumption that nocturnal akinesia is the main cause for sleep fragmentation, an evening dose of CR levodopa is frequently prescribed in clinical routine. However, evidence for the efficiency of this approach is currently lacking.
Method: Quality of sleep was assessed in two independent PD cohorts from the TRAINING-PD (n=56) and ABC-PD (n= 44) study using the Parkinson’s Disease Sleep Scale (PDSS). Nocturnal movements were assessed in a subgroup of PD patients (n=53) and healthy controls (n=16) from the TRAINING-PD study using CE-marked mobile health technology (Minimod®, McRoberts, The Netherlands).
Results: Compared to PD patients of the TRAINING-PD study without an evening dose of CR levodopa, PD patients taking CR levodopa reported lower sleep quality (PDSS sum score, p>0.001) and an increased incidence of nocturnal akinesia (PDSS Question 9, p=0.001). These results were confirmed in the ABC-PD study (PDSS sum score, p=0.042; PDSS Question 9, p=0.016). The amount and intensity of movements during the night as detected with mobile health technology was lower in PD patients compared to controls. Interestingly, PD patients with and without an evening dose of CR levodopa had comparable amount and intensity of movements during the night.
Conclusion: Our results show that, in PD, 1) low sleep quality is often associated with subjective nocturnal akinesia that can 2) not be confirmed by objective assessment of amount and intensity of movements during sleep. This finding may be due to movement difficulties that are not detected by mobile health technology. An alternative explanation could be an altered perception of nocturnal movements and sleep / sleep quality in these patients.
To cite this abstract in AMA style:
E. Schaeffer, L. Zaunbrecher, I. Liepelt-Scarfone, C. Hansen, W. Maetzler, S. Nussbaum, B. Roeben, M. Elshehabi, P. Saraykin, S. Otterbein, J. Busch, D. Berg. Influence of controlled-release levodopa on quality of sleep and nocturnal movements [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/influence-of-controlled-release-levodopa-on-quality-of-sleep-and-nocturnal-movements/. Accessed November 3, 2024.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/influence-of-controlled-release-levodopa-on-quality-of-sleep-and-nocturnal-movements/