Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson’s Disease
Diego Santos‐García, E. Suárez Castro, T. de Deus Fonticoba, Maria J. Feal Panceiras, José Guillermo Muñoz Enríquez, Jose Manuel Paz González, Carlos Cores Bartolomé, Lluís Planellás, Juan García Caldentey, Núria Caballol, Inés Legarda, I. Cabo López, Lydia López Manzanares, María A. Ávila Rivera, M.J. Catalán, Víctor Nogueira, Carmen Borrué, María Álvarez Saúco, Lydia Vela, Esther Cubo, Juan Carlos Martínez‐Castrillo, Pilar Sánchez Alonso, Maria G. Alonso Losada, Núria López Ariztegui, M. I. Gastón, Jaime Kulisevsky, Javier Pagonabarraga, Manuel Seijo, J. Ruíz Martínez, C. Valero, Mónica Kurtis, Jessica González Ardura, Cristina Párraga Prieto, Pablo Mir, Pablo Martínez‐Martín
Abstract
INTRODUCTION: The aim of the present study was to examine the frequency of self-reported sleep problems and their associated factors in a large cohort of PD patients. METHODS: PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort were included in this cross-sectional study. Sleep problems were assessed by the Spanish version of the Parkinson's disease Sleep Scale version 1 (PDSS-1). An overall score below 82 or a score below 5 on at least 1 item was defined as sleep problems. RESULTS: The frequency of sleep problems was nearly double in PD patients compared to controls: 65.8% (448/681) vs 33.5% (65/206) (p < 0.0001). Mean total PDSS score was lower in PD patients than controls: 114.9 ± 28.8 vs 132.8 ± 16.3 (p < 0.0001). Quality of life (QoL) was worse in PD patients with sleep problems compared to those without: PDQ-39SI, 19.3 ± 14 vs 13 ± 11.6 (p < 0.0001); EUROHIS-QoL8, 3.7 ± 0.5 vs 3.9 ± 0.5 (p < 0.0001). Non-motor symptoms burden (NMSS; OR = 1.029; 95%CI 1.015-1.043; p < 0.0001) and impulse control behaviors (QUIP-RS; OR = 1.054; 95%CI 1.009-1.101; p = 0.018) were associated with sleep problems after adjustment for age, gender, disease duration, daily equivalent levodopa dose, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments. CONCLUSION: Sleep problems were frequent in PD patients and were related to both a worse QoL and a greater non-motor symptoms burden in PD. These findings call for increased awareness of sleep problems in PD patients.