Comparative study of sleep disorder and its effect on health-related quality of life in patients with Parkinson's disease between early-stage and middle-and late-stages
10.3760/cma.j.issn.1671-8925.2019.01.004
- VernacularTitle:早期与中晚期帕金森病患者睡眠障碍比较及其对生活质量的影响
- Author:
Xiaohong GUI
1
;
Liping WANG
;
Chenglong WU
;
Xinfang SUN
Author Information
1. 绍兴市人民医院神经内科 312000
- Keywords:
Parkinson's disease;
Sleep disorder;
Quality of life
- From:
Chinese Journal of Neuromedicine
2019;18(1):22-27
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the characteristics of sleep disorder and its effect on health-related quality of life in patients with Parkinson's disease (PD) between early-stage and middleand late-stages.Methods One hundred and fifty-one patients collected in our hospital from September 2014 to May 2016 were divided into PD patients at early stage (grading 1-2,n=82) and PD patients at middle-and late-stages (grading 3-5,n=69) according to Hoehn-Yahr (H-Y) grading.Mini-Mental Status Examination (MMSE),Hamilton Anxiety Rating (HAM-A) scale and Hamilton Depression Rating (HAM-D) scale,Unified Parkinson's Disease Rating Scale Ⅲ (UPDRSⅢ),H-Y grading,Non-motor Symptoms Questionnaire (NMS) and Parkinson's Disease Sleep Scale (PDSS) were used to evaluate cognition states,emotion states,movement functions,disease severity,nonmotor symptoms and sleep disturbances of patients from the two groups.The 39-item Parkinson's Disease Questionnaire (PDQ-39)was used to evaluate the quality of life of PD patients.Results The incidence of sleep disorder in PD patients at middle-and late-stages was significantly higher than that in PD patients at early stage (P<0.05),and the total scores of PDSS in PD patients at middle-and late-stages were significantly lower than those in PD patients at early stage (P<0.05).Fragmented sleep (31.7% and 47.8%) and excessive sleepiness at daytime (38.7% and 43.5%) were the most common problems in patients from the two groups.Sleep disorder was negatively correlated with duration,and scores of HAM-A,HAM-D,UPDRSⅢ and H-Y grading,while it was positively correlated with MMSE scores in patients from the two groups (P<0.05).Sleep disorder was negatively correlated with NMS scores and daily levodopa equivalent dose in PD patients at middle-and late-stages (P<0.05).Multivariate regression analysis indicated that PDSS total scores were negatively correlated with HAMD scores and positively correlated with MMSE scores in all patients (P<0.05).PDSS total scores were negatively correlated with duration in PD patients at middle-and late-stages (P<0.05).Sleep disorder was negatively correlated with total scores of PDQ39,mobility,activity of daily living,communication ability and body discomfort in PD patients at middle-and late-stages (P<0.05).Conclusions The quality of sleep disorder in PD patients at middleand late-stages is worse than that in PD patients at early stage,and the quality of life is further reduced than that in PD patients at early stage.The course of disease has a great influence in sleep disorder of PD patients.