D.M. KHASANOVA¹, Z.A. ZALYALOVA^1, 2, S.E. MUNASIPOVA^1, 2

 ¹Republic Consultative and Diagnostic Center for Movement Disorders and Botulinum Therapy, Kazan

²Kazan State Medical University, Kazan

 Contact details:

Khasanova D.M. – PhD (medicine), neurologist

Address: 5 Isaeva St., Russian Federation, Kazan, 420012, tel.: +7-905-039-88-95, e-mail: diana.khasanova1987@gmail.com

 According to numerous worldwide studies, patients with Parkinson’s disease (PD) often experience sleep disturbances, the most common of which are insomnia and excessive daytime sleepiness.

The purpose of this study was to determine the quantitative and qualitative profile of sleep disorders in patients with the newly diagnosed PD, stages 1 and 2 according to Hoehn and Yahr. The assessment was carried out using the SCOPA-SLEEP scale. The study involved 95 people: 56 patients with a newly diagnosed PD, who had not previously received treatment (main group), and 39 individuals from the control group.

Results. The profile of nocturnal sleep disturbances in PD patients was characterized by various symptoms: difficulty falling asleep (62,5%), night awakening (51,8%), long lying awake (57,1%), early awakening (50,0%), feeling lack of sleep (46,4%). In women, irrespective of the form and stage of PD, disturbances in nighttime sleep were found more often. Daytime hypersomnia among healthy volunteers was observed only in 5 participants (12,8%). The profile of daytime hypersomnia in PD patients was diverse: unexpected falling asleep during the day (n = 15, 26,8%), falling asleep in a calm environment (n = 17, 30,4%) or while reading and watching TV (n = 18, 32,1%). Difficulties in maintaining wakefulness during the day were noted by 13 patients (n = 13, 23,2%) with PD, and 4 patients (7,2%) reported difficulties due to excessive daytime sleepiness. Thus, given the prevalence and profile of dyssomnias, sleep disturbances may be an important sign of PD.

Key words: Parkinson’s disease, sleep disorders, SCOPA-SLEEP, shaking form, rigid form.

REFERENCES

1. Tandberg E., Larsen J.P., Karlsen K. A community-based study of sleep disorders in patients with Parkinson’s disease. Mov. Disord, 1998, vol. 13, pp. 895–899.
2. Tandberg E., Larsen J.P., Karlsen K. Excessive daytime sleepiness and sleep benefit in Parkinson’s disease: a community-based study. Mov. Disord, 1999, vol. 14, pp. 922–927.
3. Factor S.A., McAlarney T., Sanchez-Ramos J.R., Weiner W.J. Sleep disorders and sleep effect in Parkinson’s disease. Mov. Disord, 1990, vol. 5, pp. 280–285.
4. Caap-Ahlgren M., Dehlin O. Insomnia and depressive symptoms in patients with Parkinson’s disease. Relationship to health-related quality of life. An interview study of patients living at home. Arch Gerontol Geriatr, 2001, vol. 32, pp. 23–33.
5. Pal P.K., Calne S., Samii A., Fleming J.A.E. A review of normal sleep and its disturbances in Parkinson’s disease. Parkinsonism Relat Disord, 1999, vol. 5, pp. 1–17.
6. Smith M.C., Ellgring H., Oertel W.H. Sleep disturbances in Parkinson’s disease patients and spouses. J Am Geriatr Soc, 1997, vol. 45, pp. 194–199.
7. Frucht S., Rogers J.D., Greene P.E., Gordon M.F., Fahn S. Falling asleep at the wheel: motor vehicle mishaps in persons taking pramipexole and ropinirole. Neurology, 1999, vol. 52, pp. 1908–1910.
8. Chaudhuri K.R., Pal S., Brefel-Courbon C. «Sleep attacks» or «unintended sleep episodes» occur with dopamine agonists: is this a class effect? Drug Saf, 2002, vol. 25, pp. 473–483.
9. Hobson D.E., Lang A.E., Martin W.R., Razmy A., Rivest J., Fleming J. Excessive daytime sleepiness and sudden-onset sleep in Parkinson disease: a survey by the Canadian Movement Disorders Group. JAMA, 2002, vol. 287, pp. 455–463.
10. Bargiotas P., Schuepbach M.W.M., Bassetti C.L. Sleep-wake disturbances in the premotor and early stage of Parkinson’s disease. Current Opinion in Neurology, 2016, vol. 29 (6), pp. 763–772.
11. Zalyalova Z.A. Modern concepts and prospects for the treatment of Parkinson’s disease. PM, 2004, pp. 6–8 (in Russ.).
12. Nodel’ M.R., Kovrov G.V. Sleep disorders in Parkinson’s disease: approaches to treatment and prevention. Nevrologiya, neyropsikhiatriya, psikhosomatika, 2017, no. 4 (9), pp. 88–94 (in Russ.).
13. Baig F., Lawton M., Rolinski M. Delineating nonmotor symptoms in early Parkinson’s disease and first-degree relatives. Mov Disord, 2015, vol. 30, pp. 1759–1766.
14. Claassen D.O., Josephs K.A., Ahlskog J.E. et al. REM sleep behavior disorder preceding other aspects of synucleinopathies by up to half a century. Neurology, 2010, vol. 75, pp. 494–499.
15. Pont-Sunyer C., Hotter A., Gaig C. et al. The onset of nonmotor symptoms in Parkinson’s disease (the ONSET PD study). Mov Disord, 2015, vol. 30, pp. 229–237.
16. Schrag A., Horsfall L., Walters K. et al. Prediagnostic presentations of Parkinson’s disease in primary care: a case-control study. Lancet Neurol, 2015, vol. 14, pp. 57–64.
17. Goetz C.G., Fahn S., Martinez-Martin P. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan. Movement Disorders, 2007, vol. 22 (1), pp. 41–47.
18. Hoehn M.M., Yahr M. Parkinsonism: onset, progression, and mortality. Neurology, 1967, vol. 17, pp. 427–442.
19. Marinus J., Visser M., Johannes van Hilten J., Jan Lammers G., Stiggelbout A.M. Assessment of Sleep and Sleepiness in Parkinson Disease. SLEEP, 2003, vol. 26 (8).
20. Hogl B., Seppi K., Brandauer E. Increased daytime sleepiness in Parkinson’s disease: a questionnaire survey. Mov Disord, 2003, vol. 18, pp. 319–323.
21. Trenkwalder C., Hogl B. Sleep in Parkinson syndromes. Handb Clin Neurol, 2007, vol. 83, pp. 365–376.
22. Schapira A.H.V., Chaudhuri K.R., Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci, 2017, vol. 18, pp. 435–450.
23. Chaudhuri K.R., Schapira A.H. Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol, 2009, vol. 8, pp. 464–474.
24. Freeman A.A.H. Neurochemistry of the sleep–wake cycle in Parkinson’s disease. In: Videnovic A, Högl B, editors. Disorders of sleep and circadian rhythms in Parkinson’s disease. Vienna: Springer Vienna, 2015. Pp. 19–33.
25. Videnovic A., Lazar A.S., Barker R.A., Overeem S. «The clocks that time us» — circadian rhythms in neurodegenerative disorders. Nat Rev Neurol, 2014, vol. 10, pp. 683–693.
26. idenovic A., Golombek D. Circadian and sleep disorders in Parkinson’s disease. Exp Neurol, 2013, vol. 243, pp. 45–56.
27. Monti J.M., Monti D. The involvement of dopamine in the modulation of sleep and waking. Sleep Med Rev, 2007, vol. 11, pp. 113–133.
28. Dorenbos R., Contini M., Hirasawa H. Expression of circadian clock genes in retinal dopaminergic cells. Vis Neurosci, 2007, vol. 24, pp. 573–580.
29. Witkovsky P. Dopamine and retinal function. Doc Ophthalmol, 2004, vol. 108, pp. 17–40.
30. Saper C.B., Chou T.C., Scammell T.E. The sleep switch: hypothalamic control of sleep and wakefulness. Trends Neurosci, 2001, vol. 24, pp. 726–731.
31. Wienecke M., Werth E., and Poryazova R. Progressive dopamine and hypocretin deficiencies in Parkinson’s disease: is there an impact on sleep and wakefulness? J Sleep Res., 2012, vol. 21, pp. 710–717.
32. American Academy of Sleep Medicine. The international classification of sleep disorders: diagnostic & coding manual (ICSD-3). 3rd ed. Westchester, IL: American Academy of Sleep Medicine, 2014.
33. Stefani A., Högl B. Sleep in Parkinson’s disease. Neuropsycho pharmacology, 2019, pp. 1–8.
34. Chahine L.M., Amara A.W., Videnovic A. A systematic review of the literature on disorders of sleep and wakefulness in Parkinson’s disease from 2005 to 2015. Sleep Med Rev., 2017, vol. 35, pp. 33–50.
35. Gjerstad M.D., Wentzel-Larsen T., Aarsland D., Larsen J.P. Insomnia in Parkinson’s disease: frequency and progression over time. J Neurol Neurosurg Psychiatry, 2007, vol. 78, pp. 476–479.
36. Braak H., Del Tredici K., Rub U. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging, 2003, vol. 24, pp. 197–211.
37. Tessitore A., Giordano A., De Micco R. Functional connectivity underpinnings of fatigue in Drug-Naive patients with Parkinson’s disease. Mov Disord, 2016. [Epub ahead of print]
38. Wen M.C., Ng S.Y., Heng H.S. Neural substrates of excessive daytime sleepiness in early drug naive Parkinson’s disease: A resting state functional MRI study. Parkinsonism Relat Disord, 2016, vol. 24, pp. 63–68.
39. Monaca C., Duhamel A., Jacquesson J.M. et al. Vigilance troubles in Parkinson’s disease: a subjective and objective polysomnographic study. Sleep Med, 2006, vol. 7, pp. 448–53.
40. Simuni T., Caspell-Garcia C., Coffey C. et al. Correlates of excessive daytime sleepiness in de novo Parkinson’s disease: a case control study. Mov Disord, 2015, vol. 30, pp. 1371–1381.
41. Amara A.W., Chahine L.M., Caspell-Garcia C. Longitudinal assessment of excessive daytime sleepiness in early Parkinson’s disease. J Neurol Neurosurg Psychiatry, 2017, vol. 88, pp. 653–662.
42. Kaynak D., Kiziltan G., Kaynak H. Sleep and sleepiness in patients with Parkinson’s disease before and after dopaminergic treatment. Eur J Neurol, 2005, vol. 12, pp. 199–207.
43. Buskova J., Klempir J., Majerova V. Sleep disturbances in untreated Parkinson’s disease. J Neurol, 2011, vol. 258, pp. 2254–2259.
44. Poryazova R., Benninger D., Waldvogel D., Bassetti C.L. Excessive daytime sleepiness in Parkinson’s disease: characteristics and determinants. Eur Neurol, 2010, vol. 63, pp. 129–135.
45. Abbott R.D., Ross G.W., White L.R. Excessive daytime sleepiness and subsequent development of Parkinson disease. Neurology, 2005, vol. 65, pp. 1442–1446.
46. Mollenhauer B., Zimmermann J., Sixel-Doring F. et al. Monitoring of 30 marker candidates in early Parkinson disease as progression markers. Neurology, 2016, vol. 87, pp. 168–177.