Parkinson's disease and sleepiness - An integral part of PD

被引:360
作者
Arnulf, I
Konofal, E
Merino-Andreu, M
Houeto, JL
Mesnage, V
Welter, ML
Lacomblez, L
Golmard, JL
Derenne, JP
Agid, Y
机构
[1] Hop La Pitie Salpetriere, Assistance Publ Hop Paris, Fed Pathol Sommeil, F-75651 Paris 13, France
[2] Hop La Pitie Salpetriere, Assistance Publ Hop Paris, Ctr Invest Clin, F-75651 Paris 13, France
[3] Hop La Pitie Salpetriere, Assistance Publ Hop Paris, Fed Neurol, F-75651 Paris 13, France
[4] Hop La Pitie Salpetriere, Assistance Publ Hop Paris, Serv Neuropharmacol, F-75651 Paris 13, France
[5] Hop La Pitie Salpetriere, Assistance Publ Hop Paris, INSERM, U289, F-75651 Paris 13, France
[6] Hop La Pitie Salpetriere, Assistance Publ Hop Paris, Serv Informat Med, F-75651 Paris 13, France
关键词
D O I
10.1212/WNL.58.7.1019
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To investigate the potential causes of excessive daytime sleepiness in patients with PD-poor sleep quality, abnormal sleep-wakefulness control, and treatment with dopaminergic agents. Methods: The authors performed night-time polysomnography and daytime multiple sleep latency tests in 54 consecutive levodopa-treated patients with PD referred for sleepiness, 27 of whom were also receiving dopaminergic agonists. Results: Sleep latency was 6.3 +/- 0.6 minutes (normal >8 minutes), and the Epworth Sleepiness score was 14.3 +/- 4.1 (normal <10). A narcolepsy-like phenotype (greater than or equal to2 sleep-onset REM periods) was found in 39% of the patients, who were sleepier (4.6 +/- 0.9 minutes) than the other 61% of patients (7.4 +/- 0.7 minutes). Periodic leg movement syndromes were rare (15%, range 16 to 43/h), but obstructive sleep apnea-hypopnea syndromes were frequent (20% of patients had an apnea-hypopnea index >15/h; range 15.1 to 50.0). Severity of sleepiness was weakly correlated with Epworth Sleepiness score (r = -0.34) and daily dose of levodopa (r = 0.30) but not with dopamine-agonist treatment, age, disease duration, parkinsonian motor disability, total sleep time, periodic leg movement, apnea-hypopnea, or arousal indices. Conclusions: In patients with PD preselected for sleepiness, severity of sleepiness was not dependent on nocturnal sleep abnormalities, motor and cognitive impairment, or antiparkinsonian treatment. The results suggest that sleepiness-sudden onset of sleep-does not result from pharmacotherapy but is related to the pathology of PD.
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页码:1019 / 1024
页数:6
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