Clinical Features and Correlates of Excessive Daytime Sleepiness in Parkinson's Disease
Clinical Features and Correlates of Excessive Daytime Sleepiness in Parkinson's Disease
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帕金森病白天过度嗜睡的临床特征和相关性
DOI：
10.3389/fneur.2019.00121
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发表时间：
2019
影响因子：
3.4
通讯作者：
Guo Ji feng
中科院分区：
文献类型：
--
作者：
Xiang Ya qin;Xu Qian;Sun Qi ying;Wang Zhi qin;Tian Yun;Fang Liang juan;Yang Yang;Tan Jie qiong;Yan Xin xiang;Tang Bei sha;Guo Ji feng
目的：探讨帕金森病（PD）患者日间过度嗜睡（EDS）的临床特征及其相关因素。方法：招募临床确诊或临床可能的PD患者。收集临床和人口统计学数据，并使用标准化评估方案对参与者进行评估。根据埃普沃思嗜睡量表（ESS）评分，将患者分为PD伴EDS组和PD不伴EDS组，临界评分为10分。比较两组患者的临床表现及EDS的相关因素。此外，还分析了EDS与夜间睡眠质量差的关系。结果：我们的研究共招募了1，221名PD患者。平均ESS（最小，最大）评分为7.6 ± 6.1（0，24），34.1%的患者ESS评分≥ 10。在生活方式（饮酒除外）、环境因素、BMI、左旋多巴等效剂量（LED）、运动症状的初始表现、运动亚型和磨损方面，EDS患者与非EDS患者之间无差异。PD伴EDS组的男性患者比例较高，平均患者年龄较高。此外，PD合并EDS组的PD发病年龄较大，受教育程度较低，病程较长。EDS患者的Hoehn-Yahr量表和统一帕金森病评定量表（Unified Parkinson's Disease Rating Scale，简称PDRS）第I、II和III部分评分较高，非运动症状较严重，睡眠和生活质量较差。Logistic回归分析显示，EDS与男性、年龄、认知功能障碍、PD相关睡眠问题、快速眼动睡眠行为障碍（RBD）和较差的生活质量（QoL）相关。结论：EDS是PD的普遍临床表现，有EDS与无EDS患者的临床特征存在显著差异。此外，我们的研究证明许多因素与EDS相关，包括男性性别、年龄、认知障碍、PD相关的睡眠问题、RBD和较差的生活质量。了解PD患者EDS的临床特征有助于早期发现EDS，改善生活质量，减少意外事件的发生。
Objective: To explore the clinical features and correlates of excessive daytime sleepiness (EDS) in a Chinese population of Parkinson's disease (PD) patients. Methods: Patients with clinically established or clinically probable PD were recruited. Clinical and demographic data were collected, and participants were evaluated using standardized assessment protocols. Patients were divided into PD with EDS and PD without EDS groups based on the Epworth sleepiness scale (ESS) scores, with a cutoff score of 10. Clinical manifestations were compared between patients with and without EDS, and correlates of EDS were also studied. In addition, the relationship between EDS and poor nighttime sleep quality was analyzed. Results: A total of 1,221 PD patients were recruited in our study. The mean ESS (min, max) score was 7.6 ± 6.1 (0, 24), and 34.1% of the patients had ESS scores ≥10. No difference was seen in lifestyle (except for alcohol consumption), environmental factors, BMI, levodopa equivalent dose (LED), initial presentation of motor symptoms, motor subtype, and wearing off between patients with and without EDS. The PD with EDS group had a higher proportion of male patients and a higher average patient age. Moreover, the PD with EDS group showed older age at PD onset, lower educational level, and longer disease duration. Patients with EDS had higher scores on the Hoehn-Yahr scale and the Unified Parkinson's Disease Rating Scale (UPDRS) parts I, II, and III score, more severe non-motor symptoms, and poorer quality of sleep and life. Logistic regression analyses demonstrated that EDS was associated with male sex, age, cognitive impairment, PD-related sleep problems, rapid eye movement sleep behavior disorder (RBD), and worse quality of life (QoL). Conclusion: EDS is a general clinical manifestation in PD, and there were significant differences in clinical features between patients with and without EDS. Moreover, our study proved that many factors were associated with EDS, including male sex, age, cognitive impairment, PD-related sleep problems, RBD, and worse QoL. Understanding the clinical characteristics of EDS in PD patients may help identify EDS early, improve QoL, and reduce the occurrence of accidents.