Objectives: To determine the frequency of major sleep disorders in patients with Parkinson’s disease (PD), diagnosed according to the third international classification of sleep disorders, and assess the relationship of those disorders with the quality of life. Methods: A cross-sectional study was performed involving 88 consecutive patients with PD from outpatient clinic. Participants were subjected to clinical interviews, assessment using standardized scales (Epworth Sleepiness Scale, PD Questionnaire, Pittsburgh sleep quality index (PSQI) and, for individuals with a diagnosis of RLS/WED, International RLS/WED grading scale), and video-polysomnography. Results: We observed sleep disorders in 96.5% of the participants, with REM-sleep behavior disorder found in 62.5%, obstructive sleep apnea in 62.5%, insomnia in 55.7%, and restless legs syndrome in 28.4%. We observed a correlation between health-related quality of life with the PSQI and the Epworth sleepiness scale. Conclusion: Patients with PD have a high prevalence of sleep disorders. The quality of sleep and excessive daytime sleepiness significantly affect the quality of life in these individuals.

Keywords:
Parkinson’s disease, Sleep, Sleep apnea, REM sleep behavior disorder, Quality of life
1.
Poewe W: Nonmotor Symptoms in Parkinson’s Disease; in Jankovic J, Tolosa E (eds): Parkinson’s Disease and Movement Disorders, 2007.
2.
Kumar S, Bhatia M, Behari M: Sleep disorders in parkinson’s disease. Mov Disord 2002; 17: 775–781.
3.
Lees AJ, Blackburn NA, Campbell VL: The nighttime problems of parkinson’s disease. Clin Neuropharmacol 1988; 11: 512–519.
4.
Factor SA, McAlarney T, Sanchez-Ramos JR, Weiner WJ: Sleep disorders and sleep effect in parkinson’s disease. Mov Disord 1990; 5: 280–285.
5.
Videnovic A, Golombek D: Circadian and sleep disorders in parkinson’s disease. Exp Neurol 2013; 243: 45–56.
6.
Martinez-Martin P: The importance of non-motor disturbances to quality of life in parkinson’s disease. J Neurol Sci 2011; 310: 12–16.
7.
International classification of sleep disorders, ed 2nd. Westchester, Illinois, American Academy of Sleep Medicine, 2005.
8.
Del-Ben C, Vilela J, Crippa J, Hallak J, Labate C, Zuardi A: Test-retest reliability of the structured clinical interview for dsm-iv – clinical version (scid-cv) translated into portuguese. Revista Brasileira de Psiquiatria 2001; 23: 156–159.
9.
Iber C, Ancoli-Israel S, Chesson AL, Quan SF: The Aasm Manual for Scoring of Sleep and Associated Events, ed 1st. Westchester, Illinois, American Academy of Sleep Medicine, 2007.
10.
Tandberg E, Larsen JP, Karlsen K: A community-based study of sleep disorders in patients with parkinson’s disease. Mov Disord 1998; 13: 895–899.
11.
Alatriste-Booth V, Rodríguez-Violante M, Camacho-Ordonez A, Cervantes-Arriaga A: Prevalence and correlates of sleep disorders in parkinson’s disease: a polysomnographic study. Arq Neuropsiquiatr 2015; 73: 241–245.
12.
Schulte EC, Winkelmann J: When parkinson's disease patients go to sleep: Specific sleep disturbances related to parkinson’s disease. J Neurol 2011; 258:S328–S335.
13.
Braak H, Del Tredici K, Bratzke H, Hamm-Clement J, Sandmann-Keil D, Rüb U: Staging of the intracerebral inclusion body pathology associated with idiopathic parkinson’s disease (preclinical and clinical stages). J Neurol 2002; 249(suppl 3):III/1–5.
14.
Scaglione C, Vignatelli L, Plazzi G, Marchese R, Negrotti A, Rizzo G, Lopane G, Bassein L, Maestri M, Bernardini S, Martinelli P, Abbruzzese G, Calzetti S, Bonuccelli U, Provini F, Coccagna G: Rem sleep behaviour disorder in parkinson's disease: a questionnaire-based study. Neurol Sci 2005; 25: 316–321.
15.
Gagnon JF, Bédard MA, Fantini ML, Petit D, Panisset M, Rompre S, Carrier J, Montplaisir J: Rem sleep behavior disorder and rem sleep without atonia in parkinson’s disease. Neurology 2002; 59: 585–589.
16.
da Silva-Junior FP, do Prado GF, Barbosa ER, Tufik S, Togeiro SM: Sleep disordered breathing in parkinson's disease: a critical appraisal. Sleep Med Rev 2014; 18: 173–178.
17.
Tufik S, Santos-Silva R, Taddei JA, Bittencourt LR: Obstructive sleep apnea syndrome in the sao paulo epidemiologic sleep study. Sleep Med 2010; 11: 441–446.
18.
Gjerstad MD, Wentzel-Larsen T, Aarsland D, Larsen JP: Insomnia in parkinson's disease: Frequency and progression over time. J Neurol Neurosurg Psychiatry 2007; 78: 476–479.
19.
Chung S, Bohnen NI, Albin RL, Frey KA, Müller ML, Chervin RD: Insomnia and sleepiness in parkinson disease: associations with symptoms and comorbidities. J Clin Sleep Med 2013; 9: 1131–1137.
20.
Karlsen KH, Larsen JP, Tandberg E, Maland JG: Quality of life measurements in patients with parkinson's disease: a community-based study. Eur J Neurol 1998; 5: 443–450.
21.
Gomez-Esteban JC, Zarranz JJ, Tijero B, Velasco F, Barcena J, Rouco I, Lezcano E, Lachen MC, Jauregui A, Ugarte A: Restless legs syndrome in parkinson's disease. Mov Disord 2007; 22: 1912–1916.
22.
Ondo WG, Vuong KD, Jankovic J: Exploring the relationship between parkinson disease and restless legs syndrome. Arch Neurol 2002; 59: 421–424.
23.
Loo HV, Tan EK: Case-control study of restless legs syndrome and quality of sleep in parkinson’s disease. J Neurol Sci 2008; 266: 145–149.
24.
Angelini M, Negrotti A, Marchesi E, Bonavina G, Calzetti S: A study of the prevalence of restless legs syndrome in previously untreated parkinson’s disease patients: absence of co-morbid association. J Neurol Sci 2011; 310: 286–288.
25.
Tan EK, Seah A, See SJ, Lim E, Wong MC, Koh KK: Restless legs syndrome in an asian population: a study in singapore. Mov Disord 2001; 16: 577–579.
26.
Mizuno S, Miyaoka T, Inagaki T, Horiguchi J: Prevalence of restless legs syndrome in non-institutionalized japanese elderly. Psychiatry Clin Neurosci 2005; 59: 461–465.
27.
Sevim S, Dogu O, Camdeviren H, Bugdayci R, Sasmaz T, Kaleagasi H, Aral M, Helvaci I: Unexpectedly low prevalence and unusual characteristics of rls in mersin, turkey. Neurology 2003; 61: 1562–1569.
28.
Guerreiro TM, Nishikawa DR, Ferreira LC, Melo HA, Prado RC: Restless legs syndrome in parkinson’s disease: clinical characteristics and biochemical correlations. Arq Neuropsiquiatr 2010; 68: 869–872.
29.
Walters AS: Toward a better definition of the restless legs syndrome. The international restless legs syndrome study group. Mov Disord 1995; 10: 634–642.
30.
Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J: Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the national institutes of health. Sleep Med 2003; 4: 101–119.
31.
Hogl B, Stefani A: Restless legs syndrome and periodic leg movements in patients with movement disorders: specific considerations. Mov Disord 2017; 32: 669–681.
32.
Eckeli AL, Gitai LL, Dach F, Ceretta H, Sander HH, Passos AD, do Prado GF, Fernandes RM: Prevalence of restless legs syndrome in the rural town of cassia dos coqueiros in brazil. Sleep Med 2011; 12: 762–767.
33.
Moller JC, Unger M, Stiasny-Kolster K, Oertel WH: Restless legs syndrome (rls) and parkinson’s disease (pd)-related disorders or different entities? J Neurol Sci 2010; 289: 135–137.
34.
Carod-Artal FJ, Vargas AP, Martinez-Martin P: Determinants of quality of life in brazilian patients with parkinson’s disease. Mov Disord 2007; 22: 1408–1415.
35.
Schrag A, Jahanshahi M, Quinn N: What contributes to quality of life in patients with parkinson’s disease? J Neurol Neurosurg Psychiatry 2000; 69: 308–312.
36.
Marras C, McDermott MP, Rochon PA, Tanner CM, Naglie G, Lang AE: Predictors of deterioration in health-related quality of life in parkinson’s disease: results from the datatop trial. Mov Disord 2008; 23: 653–659; quiz 776.
37.
Hindle JV: The practical management of cognitive impairment and psychosis in the older parkinson’s disease patient. J Neural Transm 2013; 120: 649–653.
38.
Postuma RB, Gagnon JF, Vendette M, Charland K, Montplaisir J: Manifestations of parkinson disease differ in association with rem sleep behavior disorder. Mov Disord 2008; 23: 1665–1672.
39.
Scaravilli T, Gasparoli E, Rinaldi F, Polesello G, Bracco F: Health-related quality of life and sleep disorders in parkinson’s disease. Neurol Sci 2003; 24: 209–210.
40.
Martinez-Martin P, Rodriguez-Blazquez C, Forjaz MJ, Alvarez-Sanchez M, Arakaki T, Bergareche-Yarza A, Chade A, Garretto N, Gershanik O, Kurtis MM, Martinez-Castrillo JC, Mendoza-Rodriguez A, Moore HP, Rodriguez-Violante M, Singer C, Tilley BC, Huang J, Stebbins GT, Goetz CG: Relationship between the mds-updrs domains and the health-related quality of life of parkinson’s disease patients. Eur J Neurol 2014; 21: 519–524.
41.
Arnulf I, Leu-Semenescu S: Sleepiness in parkinson’s disease. Parkinsonism Relat Disord 2009; 15(suppl 3):S101–S104.
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2017
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