Objective: The aim of this longitudinal study is to examine which factors are associated with longitudinal changes and future occurrence of nighttime sleep problems (NSP) among individuals with Parkinson’s disease (PD).

Background: In patients with PD, NSP mostly consist of sleep fragmentation and early awakenings. The longitudinal course, associated factors and risk factors for NSP have thus far poorly been investigated.

Methods: Analyses were performed in data of the SCOPA-PROPARK cohort, a 5-year hospital-based longitudinal cohort of over 400 PD patients who have been examined annually. Cross-sectional analyses were conducted to evaluate differences between patients with (SCOPA-SLEEP NS ≥ 7) and without nighttime sleep problems at baseline, while linear mixed models using data of all patients were used to identify factors associated with longitudinal changes in SCOPA-SLEEP NS scores. A survival analysis using data of patients without NSP at baseline was performed to identify risk factors for the future occurrence of this symptom.

Results: At baseline, 27% of patients had NSP, while 33% of patients without this condition at baseline developed NSP at some point during follow-up. The proportion of patients with NSP increased slightly over time (from 10 to 18%), but NSP proved not a persistent feature. Higher severity of motor fluctuations, excessive daytime sleepiness (EDS), urinary tract symptoms, higher baseline depression scores (Beck Depression Inventory [BDI]) and higher dopamine agonist dosages were associated with higher SCOPA-SLEEP NS scores over time. Higher BDI scores and higher baseline SCOPA-SLEEP NS scores were independent risk factors for the development of future NSP.

Conclusions: NSP is not a persistent phenomenon in PD, although persistency increases with longer disease duration. Patients with motor fluctuations, excessive daytime sleepiness (EDS), urinary tract symptoms, higher dopamine agonists dosages and depression at baseline are at increased risk of future development of this symptom.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/nighttime-sleep-problems-in-patients-with-parkinsons-disease-risk-factors-and-longitudinal-associations/