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Insomnia, Sleep Quality, and Quality of Life in Mild to Moderate Parkinson’s Disease.

Insomnia, Sleep Quality, and Quality of Life in Mild to Moderate Parkinson’s Disease.
Author Information (click to view)

Shafazand S, Wallace DM, Arheart KL, Vargas S, Luca CC, Moore H, Katzen H, Levin B, Singer C,


Shafazand S, Wallace DM, Arheart KL, Vargas S, Luca CC, Moore H, Katzen H, Levin B, Singer C, (click to view)

Shafazand S, Wallace DM, Arheart KL, Vargas S, Luca CC, Moore H, Katzen H, Levin B, Singer C,

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Annals of the American Thoracic Society 2017 02 23() doi 10.1513/AnnalsATS.201608-625OC
Abstract
RATIONALE
Sleep disorders are prevalent in Parkinson’s disease and yet under reported in clinical settings. The contribution of sleep disorders to health-related quality of life (HRQOL) for patients with this degenerative neurological disease are not well known.

OBJECTIVES
To evaluate the impact of insomnia symptoms, obstructive sleep apnea (OSA), and poor sleep quality on HRQOL in a cohort of patients with idiopathic Parkinson’s disease.

METHODS
We enrolled a convenience sample of 66 adults seen in the University of Miami Movement Disorders Clinic between July 2011 and June 2013. Participants completed validated questionnaires to determine insomnia symptoms, risk for OSA, depression, anxiety, and HRQOL. All patients underwent unattended polysomnography to confirm OSA. Results were compared for those with and without insomnia symptoms. Principal component and regression analyses were performed to evaluate determinants of HRQOL.

MEASUREMENTS AND MAIN RESULTS
Participants were predominately Hispanic males with mild to moderate Parkinson’s disease. Insomnia symptoms were reported in 46% of the study subjects. OSA (AHI ≥ 5) was noted in 47%, with mean AHI of 8.3 ± 11.0. Fairly to very bad sleep quality was reported by 21% of the participants. Insomnia (r=0.71, p <0.001), daytime sleepiness (r=0.36, p=0.003), depression symptoms (r= 0.44, p <0.001), and symptoms of anxiety (r=0.33, p=0.006) were significant correlates of poor sleep quality. OSA, severity of Parkinson's disease, and dopaminergic therapy were not. In the principal component analysis, sleep quality was a significant component of the "psychological factor" that in turn was a significant determinant of overall HRQOL. CONCLUSIONS
Insomnia symptoms, OSA, and subsequent poor sleep quality are prevalent in Parkinson’s disease. In this single-center, exploratory study, we found that insomnia and poor sleep quality, but not OSA, play important roles in determining overall quality of life for patients with this disease. Clinical trial registered with clinicaltrials.gov (NCT02034357).

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