Sleep quality, excessive daytime sleepiness, and depression in Parkinson's disease: implications for improved patient outcomes

Abstract

Objectives: Sleep disorders are frequently encountered non-motor symptoms that significantly impact the lifestyle quality of individuals with Parkinson's disease (PD). Our research endeavors to research the sleep quality of PD patients and define the occurrence of excessive daytime sleepiness (EDS) and nocturnal difficulties within this population.

Methods: We incorporated 140 patients diagnosed with PD and 75 healthy individuals as controls. The modified Hoehn & Yahr Staging Scale (HYS) was employed for the clinical classification of PD stages, while the evaluation of clinical intensity utilized the Unified Parkinson's Disease Rating Scale (UPDRS). The assessment of sleep quality utilized the Pittsburgh Sleep Quality Index (PSQI), along with the Parkinson's Disease Sleep Scale (PDSS), and the Epworth Sleepiness Scale (ESS). Additionally, the subjective depression levels of attendees were assessed by the Beck Depression Inventory.

Results: In contrast to the healthy controls, the patient cohort demonstrated notably higher scores across the PSQI scale, ESS, and Beck Depression Scale (p < 0.05). Within the PD patient group, 66.4% exhibited poor sleep quality, and 17.1% reported excessive daytime sleepiness. A significant positive correlation was between poor sleep quality and factors such as H&Y stage, duration of levodopa exposure, scores on the ESS, and the BDI (p < 0.05). Additionally, EDS was positively correlated with UPDRS-I scores, Levodopa equivalent daily dose, PSQI, and BDI scores (p < 0.05).

Discussion: Addressing the specific etiology of sleep disorders in Parkinson's patients has the potential to result in improved treatment outcomes and enhanced functionality in their daily lives.

Keywords: Epworth; PDSS; Parkinson’s disease; Pittsburgh; Sleep quality; depression; excessive daytime sleepiness.