Excessive daytime sleepiness in Parkinson's disease: characteristics and determinants.
Détails
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Accès restreint UNIL
Etat: Public
Version: Final published version
Accès restreint UNIL
Etat: Public
Version: Final published version
ID Serval
serval:BIB_5FE4289D57D9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Excessive daytime sleepiness in Parkinson's disease: characteristics and determinants.
Périodique
European Neurology
ISSN
1421-9913 (Electronic)
ISSN-L
0014-3022
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
63
Numéro
3
Pages
129-135
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish. PDF type: Review
Résumé
BACKGROUND/AIMS: Excessive daytime sleepiness (EDS) is frequent in patients with Parkinson's disease (PD). Occasionally, EDS in PD exhibits narcolepsy-like features. We aimed to assess characteristics and determinants of EDS in consecutive patients with PD.
METHODS: Thirty consecutive patients with PD underwent a detailed clinical examination. EDS was assessed using the Epworth Sleepiness Scale (ESS) and Multiple Sleep Latency Test (MSLT). Sleep was assessed using video-polysomnography. Cerebrospinal fluid (CSF) hypocretin-1 levels were obtained in 3 patients.
RESULTS: ESS was >10 in 17 patients (57%). Mean sleep latency (MSL) on MSLT was <5 min in 11 patients (37%). There was a significant negative correlation between ESS and MSL. None of the 11 patients with MSL <5 min showed a sleep onset REM (SOREM) episode. Patients with EDS had higher dopamine agonists/levodopa equivalent doses, higher apnea/hypopnea index and exhibited wearing-off symptoms more often. Hypocretin-1 was normal in 3 patients tested.
CONCLUSION: EDS, which can sometimes be severe, is common in PD patients even in the absence of SOREM and detectable CSF-hypocretin deficiency. In PD, EDS is a multifaceted phenomenon, the determinants of which include severity of PD, wearing-off symptoms, dosage of antiparkinsonian drugs and sleep-disordered breathing.
METHODS: Thirty consecutive patients with PD underwent a detailed clinical examination. EDS was assessed using the Epworth Sleepiness Scale (ESS) and Multiple Sleep Latency Test (MSLT). Sleep was assessed using video-polysomnography. Cerebrospinal fluid (CSF) hypocretin-1 levels were obtained in 3 patients.
RESULTS: ESS was >10 in 17 patients (57%). Mean sleep latency (MSL) on MSLT was <5 min in 11 patients (37%). There was a significant negative correlation between ESS and MSL. None of the 11 patients with MSL <5 min showed a sleep onset REM (SOREM) episode. Patients with EDS had higher dopamine agonists/levodopa equivalent doses, higher apnea/hypopnea index and exhibited wearing-off symptoms more often. Hypocretin-1 was normal in 3 patients tested.
CONCLUSION: EDS, which can sometimes be severe, is common in PD patients even in the absence of SOREM and detectable CSF-hypocretin deficiency. In PD, EDS is a multifaceted phenomenon, the determinants of which include severity of PD, wearing-off symptoms, dosage of antiparkinsonian drugs and sleep-disordered breathing.
Mots-clé
Aged, Aged, 80 and over, Antiparkinson Agents/therapeutic use, Disorders of Excessive Somnolence/complications, Disorders of Excessive Somnolence/physiopathology, Humans, Intracellular Signaling Peptides and Proteins/cerebrospinal fluid, Middle Aged, Neuropeptides/cerebrospinal fluid, Parkinson Disease/complications, Parkinson Disease/drug therapy, Polysomnography, Time
Pubmed
Web of science
Open Access
Oui
Création de la notice
08/10/2012 9:43
Dernière modification de la notice
20/08/2019 14:17