Objective: Compare sleep disturbances between VP and PD patients.

Background: Sleep disorders in PD patients are well recognized, ranging from nocturnal symptoms such as insomnia, REM sleep behavioural disorder and nocturia, to diurnal manifestations as excessive daytime sleepiness and sleep attacks. Considering VP, its relationship with sleep problems is not so well documented, although recent reports have pointed to a high prevalence of these disturbances.

Method: Cross-sectional comparative study of 49 patients (VP: 16 and PD: 33) with clinically suspected VP (Zijlmans et al and/or Winikates and Jankovic scales) and PD (UK Parkinson´s Disease Society Brain Bank Clinical diagnostic criteria) patients observed in the Movement Disorder Unit of Centro Hospitalar de Trás-os-Montes e Alto Douro since 2015. Analyses were performed with the use of SPSS Statistics, version 25.0.

Results: Of 49 patients, 55.1% were male. Patients with VP were older and had shorter duration of disease as compared to PD patients. Hoehn and Yahr scale was significantly higher in the VP patients (p<0.01). Considering the Parkinson’s Disease Sleep Scale (PDSS-2), there were no significant differences between PD (12.21±0.904) and VP patients (12.06±1.260) (p=0.924), in consonance with the results from the domain 2 (sleep/fatigue) of the Non-Motor Symptom assessment scale for Parkinson’s Disease (although the median was slightly higher in VP vs PD patients: 6 vs 3, p=0.234). Regarding comorbidities, VP patients had a discrete superior prevalence of obstructive sleep apnea and benign prostatic hyperplasia, however with no statistical significance.

Conclusion: We found no differences in the frequency of sleep disturbances between PD and VP patients in early stages, demonstrating that VP patients have as PD a high prevalence of these disorders, in line with the literature. These manifestations should be addressed equally in both parkinsonisms, in order to improve patient’s quality of life.

References: Bhidayasiri R, Jitkritsadakul O, Petchrutchatachart S, Kaewwilai L, Panyakaew P, Boonrod N, et al. Nocturnal manifestations of atypical and vascular parkinsonism: How do they differ from Parkinson’s disease? J Neural Transm (Vienna) 2014; 121 Suppl 1:S69-77. Berganzo K, Tijero B, González-Eizaguirre A, Somme J, Lezcano E, Gabilondo I, et al. Motor and non-motor symptoms of Parkinson’s disease and their impact on quality of life and on different clinical subgroups. Neurología 2016; 31:585-591. Levin O, Chimagomedova A, Skripkina N, Lyashenko E, Babkina O. Nonmotor Symptoms in Vascular and Other Secondary Parkinsonism. Int Rev Neurobiol 2017; 134:1303-1334. Crosta F, Desideri G, Marini C. Obstructive sleep apnea syndrome in Parkinson’s disease and other parkinsonisms. Funct Neurol 2017; 32(3):137-141. Baumann C. Sleep-wake and circadian disturbances in Parkinson disease: a short clinical guide. J Neural Transm (Vienna) 2019; 126(7):863-869.

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