Anxiety and Levodopa Equivalent Daily Dose Are Potential Predictors of Sleep Quality in Patients With Parkinson Disease in Taiwan
Anxiety and Levodopa Equivalent Daily Dose Are Potential Predictors of Sleep Quality in Patients With Parkinson Disease in Taiwan
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DOI：
10.3389/fneur.2019.00340
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发表时间：
2019-04-16
影响因子：
3.4
通讯作者：
Wu, Yih-Ru
中科院分区：
文献类型：
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作者：
Chang, Chun-Wei;Fan, Jun-Yu;Wu, Yih-Ru
背景和目的：帕金森病（PD）的非运动症状对PD患者的健康相关生活质量（QoL）有很强的负面影响。睡眠障碍是一种重要的非运动症状，因为它的患病率很高。然而，以前的研究调查PD患者睡眠质量的决定因素，结果不一致。我们的研究评估了PD患者的睡眠质量与疾病相关变量之间的相关性，药物治疗抑郁症，焦虑症，生活质量和确定的决定因素，睡眠障碍的人PD在Taiwan.Methods：共134例PD患者从门诊招募。我们研究了帕金森病睡眠量表-2（PDSS-2）评分与不同变量（即统一帕金森病评定量表、帕金森病问卷、贝克抑郁量表和贝克焦虑量表（BAI））之间的相关性。Logistic回归分析用于评估PD患者睡眠质量的潜在预测变量。结果：在我们的参与者中，47.8%被归类为睡眠不良者（PDSS-2 = 15-60）。相关性分析表明，睡眠差的患者表现出更长的疾病持续时间，更高的左旋多巴等效日剂量（LEDDs），更高的PD严重程度，更多的抑郁和焦虑症状，更差的生活质量，更频繁的失业状态，更高的催眠药使用，更高的日常生活活动的依赖性，更多的运动障碍，和更多的治疗相关并发症。Logistic回归分析显示，LEDD是一个显着的睡眠quality.Conclusion预测因素：睡眠不良构成了大约一半的PD患者。如果参与者目前正在工作，他们会有更好的睡眠。PD持续时间、严重程度、抑郁或焦虑症状以及多巴胺能治疗剂量的增加与睡眠质量差显著相关。继续工作，尝试治疗共病焦虑或抑郁，避免多巴胺能治疗过量可能会改善PD患者的睡眠质量。
Background and Purpose: Non-motor symptoms of Parkinson disease (PD) have a strong negative impact on the health-related quality of life (QoL) of patients with PD. Sleep disturbance is an important non-motor symptom because of its high prevalence. However, previous studies investigating the determinants of sleep quality in patients with PD have revealed inconsistent results. Our study evaluated the correlations between sleep quality in patients with PD and disease-related variables, medications used depression, anxiety, and QoL and identified the determinants of sleep disturbance in people with PD in Taiwan.Methods: A total of 134 patients with PD were recruited from the outpatient clinic. We examined the correlations between the Parkinson disease sleep scale-2 (PDSS-2) scores and different variables, namely the Unified Parkinson Disease Rating Scale, Parkinson disease questionnaire, Beck Depression Inventory, and Beck Anxiety Inventory (BAI). Logistic regression analysis was used to assess the potential predictive variables for sleep quality in patients with PD.Results: Among our participants, 47.8% were classified as poor sleepers (PDSS-2 = 15-60). Correlation analysis demonstrated that poor sleepers exhibited longer disease durations, higher levodopa equivalent daily doses (LEDDs), higher PD severity, more depression and anxiety symptoms, poorer QoL, more frequent unemployed status, higher hypnotics use, higher dependency for activities of daily living, more motor impairments, and more therapy-related complications. Logistic regression revealed that the LEDD was a significant predictive factor of sleep quality.Conclusion: Poor sleepers constituted approximately half of our patients with PD. The participants experienced more favorable sleep if they were currently working. Increased PD duration, severity, depression or anxiety symptoms, and doses of dopaminergic therapy were significantly associated with poor sleep quality. Continued working, attempts to treat comorbid anxiety or depression, and avoidance of overdosage of dopaminergic treatments may improve sleep quality in patients with PD.