2.Fatigue correlates with sleep disturbances in Parkinson disease.
Xiang-Yang CAO ; Jin-Ru ZHANG ; Yun SHEN ; Cheng-Jie MAO ; Yu-Bing SHEN ; Yu-Lan CAO ; Han-Ying GU ; Fen WANG ; Chun-Feng LIU
Chinese Medical Journal 2020;134(6):668-674
BACKGROUND:
Many Parkinson disease (PD) patients complain about chronic fatigue and sleep disturbances during the night. The objective of this study is to determine the relationship between fatigue and sleep disturbances by using polysomnography (PSG) in PD patients.
METHODS:
Two hundred and thirty-two PD patients (152 with mild fatigue and 80 with severe fatigue) were recruited in this study. Demographic information and clinical symptoms were collected. Fatigue severity scale (FSS) was applied to evaluate the severity of fatigue, and PSG was conducted in all PD patients. FSS ≥4 was defined as severe fatigue, and FSS <4 was defined as mild fatigue. Multivariate logistic regression and linear regression models were used to investigate the associations between fatigue and sleep disturbances.
RESULTS:
Patients with severe fatigue tended to have a longer duration of disease, higher Unified Parkinson Disease Rating Scale score, more advanced Hoehn and Yahr stage, higher daily levodopa equivalent dose, worse depression, anxiety, and higher daytime sleepiness score. In addition, they had lower percentage of rapid eye movement (REM) sleep (P = 0.009) and were more likely to have REM sleep behavior disorder (RBD) (P = 0.018). Multivariate logistic regression analyses found that the presence of RBD and proportion of REM sleep were the independent predictors for fatigue. After the adjustment of age, sex, duration, body mass index, severity of disease, scores of Hamilton Rating Scale for Depression, Hamilton Anxiety Rating Scale, and other sleep disorders, proportion of REM sleep and degree of REM sleep without atonia in patients with PD were still associated with FSS score.
CONCLUSION
Considering the association between fatigue, RBD, and the altered sleep architecture, fatigue is a special subtype in PD and more studies should be focused on this debilitating symptom.
Humans
;
Parkinson Disease/complications*
;
Polysomnography
;
REM Sleep Behavior Disorder
;
Sleep
;
Sleep Wake Disorders/etiology*
6.Investigation of sleep disturbance and related factors in patients with primary Sjögren's syndrome.
Yi Fan WANG ; Zhen FAN ; Yao Bin CHENG ; Yue Bo JIN ; Yang HUO ; Jing HE
Journal of Peking University(Health Sciences) 2020;52(6):1063-1068
OBJECTIVE:
To investigate the prevalence of sleep disorders and the relevant determinants in a cohort of primary Sjögren' s syndrome (pSS) patients.
METHODS:
One hundred and eighty-six pSS patients were included in the study, who were admitted to Peking University People' s Hospital and met the criteria of inclusion and exclusion. Sleep quality was assessed using the Pittsburgh sleep quality index(PSQI).Depression, anxiety were evaluated by patient health questionnaire (PHQ)-9, generalized anxiety disorder(GAD)-7, respectively. The demographic and clinical data were also recorded.Disease activity and damage were evaluated with the European League Against Rheumatism Sjögren's syndrome disease activity index (ESSDAI). According to the PSQI score>7, the pSS patients were divided into 152 cases of sleep disorder group and 34 cases of normal sleep group. Mann-Whitney U test, Chi-square test or Fisher' s exact test, independent samples t test, Spearman correlation analysis and Logistic regression were used for statistical analysis.
RESULTS:
The prevalence of sleep disturbance (PSQI > 7) was 81.7% (152 / 186) in the pSS patients, and 52.7% (98/186) had moderate or severe sleep disorders (PSQI≥ 11). The mean PSQI score of sleep disordered group was (12.29±3.30), while the normal sleep group PSQI score was (5.50±1.20). The PSQI score, PHQ-9 score and GAD-7 score in the sleep-disordered group were significantly higher than those in the normal sleep group (P=0.000, 0.035, 0.031). The PSQI score in the sleep disordered group were significantly higher than those in the normal sleep group in seven aspects: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disorders, hypnotic drug use and daytime dysfunction. All of them had statistical significance. According to the results of Spearman correlation analysis, PSQI had significantly positive correlation with course of disease, anxiety, depression score (r=0.151, 0.240, 0.421, P < 0.05), but negatively correlated with C3, C4 (r=-0.021, -0.235, P < 0.05). Logistic analysis identified the course of disease(OR=2.809, 95%CI: 1.21-6.52)and PHQ-9 score(OR=1.422, 95%CI: 1.04-1.94)as predictors of sleep disorders.
CONCLUSION
The incidence of sleep disorder in the pSS patients was higher, which was closely related to the course of disease, anxiety, depression and other factors. It is critical to assess and manage comprehensively the disease.
Anxiety/etiology*
;
Cohort Studies
;
Humans
;
Sjogren's Syndrome/epidemiology*
;
Sleep
;
Sleep Wake Disorders/epidemiology*
7.Epilepsy and sleep disorders.
Chinese Journal of Contemporary Pediatrics 2009;11(5):415-417
8.Relationship of changes in sleep architecture and cognitive function in patients with obstructive sleep apnea syndrome.
Yan XU ; Shun-wei LI ; Xi-zhen HUANG ; Bo CONG
Acta Academiae Medicinae Sinicae 2002;24(6):632-634
OBJECTIVESTo explore the relationship between sleep architecture changes and cognitive impairment in patients with obstructive sleep apnea syndrome (OSAS).
METHODSThirty-six patients with OSAS and 18 controls were administered polysomnography and neuropsychological tests of visual regeneration, digital symbol, comprehensive memory and digital span.
RESULTSPerformances on the visual regeneration test and digital symbol test in patients with OSAS were impaired significantly compared with the control group (P < 0.01). Patients' performance on the visual regeneration test was significantly associated with slow wave sleep duration (r = 0.423, P < 0.05) and that on the digital symbol test was significantly associated with REM sleep duration (r = 0.378, P < 0.05).
CONCLUSIONSSlow wave sleep and REM sleep derivation may play a role in the cognitive impairment in patients with OSAS.
Adult ; Cognition Disorders ; etiology ; Humans ; Male ; Middle Aged ; Polysomnography ; REM Sleep Behavior Disorder ; etiology ; Sleep Apnea, Obstructive ; complications ; psychology ; Sleep Stages ; physiology ; Sleep, REM
9.Macrostructure of sleep in patients with vascular cognitive impairment-no dementia.
Mu-feng ZHU ; Li-ying DENG ; Li-min GONG ; Hao LIU ; Yong-min DING
Journal of Southern Medical University 2011;31(2):295-298
OBJECTIVETo investigate the sleep structure in patients with vascular cognitive impairment-no dementia (VCI-ND) and its differences from that of normal individuals.
METHODSThe whole night sleep record of 20 patients with VCI-ND were monitored by 32-head video-taped polysomnographic system, and the results were compared with the data of 20 normal subjects.
RESULTSCompared with normal subjects, patients with VCI-ND showed significantly reduced total sleep duration, increased waking times, increased stage 1 sleep, decreased stage 2 sleep, decreased stage 3 sleep, decreased rapid eye movement stage (REM) and reduced sleep efficiency.
CONCLUSIONIncreased light sleep as well as decreased slow-wave stage 3-4 sleep and decreased REM stage may be a specific electroneurophysiologic marker for VCI-ND, but large-sampled multi-centered randomized controlled trial is necessary to test the validity of these features as specific markers for screening and early diagnostic purposes.
Aged ; Case-Control Studies ; Cognition Disorders ; diagnosis ; etiology ; physiopathology ; Dementia, Vascular ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; Sleep ; physiology ; Sleep Stages ; Sleep Wake Disorders ; etiology ; Stroke ; complications
10.Updated relationship between sleep and erectile function.
National Journal of Andrology 2016;22(3):252-257
Penile erection (PE) is a physiological phenomenon involving complex mechanisms. PE may occur as reactive erections, psychogenic erections in the conscious state and spontaneous erections during the sleep. Sleep-related PE refers to the erections occurring spontaneously during the sleep with rapid eye movement. Studies have shown a correlation between sleep and PE as well as between sleep disorders and erectile dysfunction but not yet revealed the exact mechanisms. This paper updates the relationship between sleep and erectile function.
Erectile Dysfunction
;
etiology
;
Humans
;
Male
;
Penile Erection
;
physiology
;
Sleep
;
physiology
;
Sleep Wake Disorders
;
complications
;
Sleep, REM
;
physiology