1.Sleep benefit and its correlation factors in Parkinson's disease
Xia DU ; Linliu PENG ; Chengyue SUN ; Yiming LIU
Chinese Journal of Neurology 2018;51(8):570-575
Objective To analyze the phenomenon of sleep benefit in Parkinson's disease (PD)and its correlation factors.Methods One hundred PD patients in Department of Neurology,Qilu Hospital of Shandong University from February 2017 to November 2017 were included.They were recorded in detail the clinical information and clinical classification.Sleep conditions were assessed by Pittsburgh Sleep Quality Index,Parkinson Disease Sleep Scale,Epworth Sleepiness Disorder Scale and Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire.The general information,disease duration,medication,movement function,sleep condition and anxiety status were compared between sleep benefit group and without sleep benefit group.The correlation factors of sleep benefit was evaluated using unconditional Logistic regression analysis.Results Fifty-one cases (51%) of sleep benefit were determined in our cohort of 100 PD patients.Sleep benefit group adminstered lower levodopa equivalent daily dose (LEDD,(354.77 ± 279.64) mg/d) compared with patients without sleep benefit ((510.76 ± 266.26) mg/d,t =-2.734,P =0.006),including levodopa ((289.04 ± 228.73) mg/d vs (392.65 ± 211.20) mg/d,t =-2.366,P =0.021) and dopamine agonist dose ((41.13 ± 51.48) mg/d vs (68.01 ± 57.10) mg/d,t =-1.950,P =0.054).Sleep benefit group had higher percentage of using dopamine agonist (23(45.1%) vs 35 (71.4%),x2 =7.112,P=0.008) and longer duration of nocturnal sleep episode ((6.51 ± 1.31) h vs (5.89 ± 1.29) h,t =2.412,P =0.018).In addition,sleep benefit had a higher prevalence in tremor-dominant subtype of PD (19/27 (70.4%) vs 20/46 (43.5%),x2 =4.855,P =0.025).Logistic regression indicated that sleep benefit had a positive correlation with duration of nocturnal sleep episode and tremor-dominant subtype,as well as a negative correlation with LEDD and dose of levodopa.LEDD and duration of nocturnal sleep episode were the independent factors of sleep benefit (OR =0.998,95%CI 0.997-1.000,P<0.05;OR=1.407,95%CI1.004-1.972,P<0.05).Conclusion PD patients with sleep benefit administered low dose of dopamine and took long nocturnal sleep,which may relate to the relativelv preserved dopamine storage function of dopaminergic neurons.