Background: Sleep disturbance is a common problem among patients with Parkinson’s disease (PD). Objectives: To investigate the prevalence of daytime somnolence and night-time sleep disturbances; to characterise the night-time sleep disturbance in patients with daytime somnolence; and to determine the correlation between daytime somnolence and night-time sleep disturbances. Methods: One hundred and sixty patients with PD were included in the study. Each patient completed the Thai version of the Epworth Sleepiness Scale (ESS) questionnaire to evaluate excessive daytime sleepiness (EDS), and the PD Sleep Scale version-2 (PDSS-2) questionnaire to evaluate night-time sleep disturbance. Subjective sleep information and details about the presence or absence of sleep attack (SA) were also obtained from the patients. Results: The types of daytime somnolence found in this study were EDS, SA, and combination of EDS and SA (EDS + SA) with the prevalence rates of 22.5, 3.1 and 6.3%, respectively. The prevalence of night-time sleep disturbance was 46.9%. The most common nocturnal disturbance (82.5%) was “get up at night to pass urine”. There was a significant positive correlation between the ESS score and PDSS-2 total score with a correlation coefficient of 0.16 (p = 0.043). Patients with “EDS + SA” were the most affected by nocturnal disturbances, as they represented the largest group among those patients with night-time disturbances and had the highest PDSS-2 total score (p < 0.05). Conclusion: There are differences in nocturnal sleep disturbances among PD patients with different types of daytime somnolence. The significant positive correlation between the ESS and the PDSS-2 total scores suggests that night-time sleep disturbance may influence daytime somnolence.

1.
Bhidayasiri R, Mekawichai P, Jitkritsadakul O, Panyakaew P, Kaewwilai L, Boonrod N, et al: Nocturnal journey of body and mind in Parkinson’s disease: the manifestations, risk factors and their relationship to daytime symptoms. Evidence from the NIGHT-PD study. J Neural Transm (Vienna) 2014; 121: 59–68.
2.
Comella CL: Sleep disorders in Parkinson’s disease: an overview. Mov Disord 2007; 22(suppl 17):S367–S373.
3.
Chahine LM, Amara AW, 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; 35: 33–50.
4.
Homann CN, Wenzel K, Suppan K, Ivanic G, Kriechbaum N, Crevenna R, et al: Sleep attacks in patients taking dopamine agonists: review. BMJ 2002; 324: 1483–1487.
5.
Schlesinger I, Ravin PD: Dopamine agonists induce episodes of irresistible daytime sleepiness. Eur Neurol 2003; 49: 30–33.
6.
Yeung EY, Cavanna AE: Sleep attacks in patients with Parkinson’s disease on dopaminergic medications: a systematic review. Mov Disord Clin Pract 2014; 1: 307–316.
7.
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.
8.
Viwattanakulvanid P, Kaewwilai L, Jitkritsadakul O, Brenden NR, Setthawatcharawanich S, Boonrod N, et al: The impact of the nocturnal disabilities of Parkinson’s disease on caregivers’ burden: implications for interventions. J Neural Transm (Vienna) 2014; 121:S15–S24.
9.
Tavora DG, de Bruin VM, Gama R, Lopes EM, Jorge IF, de Bruin PF: The nature of excessive sleepiness and sudden sleep onset in Parkinson’s disease. Sleep Sci 2014; 7: 13–18.
10.
Yu RL, Tan CH, Wu RM: The impact of nocturnal disturbances on daily quality of life in patients with Parkinson’s disease. Neuropsychiatr Dis Treat 2015; 11: 2005–2012.
11.
Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14: 540–545.
12.
Hagell P, Broman JE: Measurement properties and hierarchical item structure of the Epworth Sleepiness Scale in Parkinson’s disease. J Sleep Res 2007; 16: 102–109.
13.
Banhiran W, Assanasen P, Nopmaneejumruslers C, Metheetrairut C: Epworth sleepiness scale in obstructive sleep disordered breathing: the reliability and validity of the Thai version. Sleep Breath 2011; 15: 571–577.
14.
Trenkwalder C, Kohnen R, Hogl B, Metta V, Sixel-Doring F, Frauscher B, et al: Parkinson’s disease sleep scale – validation of the revised version PDSS-2. Mov Disord 2011; 26: 644–652.
15.
Tan EK, Lum SY, Fook-Chong SM, Teoh ML, Yih Y, Tan L, et al: Evaluation of somnolence in Parkinson’s disease: comparison with age-and sex-matched controls. Neurology 2002; 58: 465–468.
16.
Borek LL, Kohn R, Friedman JH: Mood and sleep in Parkinson’s disease. J Clin Psychiatry 2006; 67: 958–963.
17.
Brodsky MA, Godbold J, Roth T, Olanow CW: Sleepiness in Parkinson’s disease: a controlled study. Mov Disord 2003; 18: 668–672.
18.
Paus S, Brecht HM, Köster J, Seeger G, Klockgether T, Wüllner U: Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson’s disease. Mov Disord 2003; 18: 659–667.
19.
Suzuki K, Miyamoto T, Miyamoto M, Okuma Y, Hattori N, Kamei S, et al: Excessive daytime sleepiness and sleep episodes in Japanese patients with Parkinson’s disease. J Neurol Sci 2008; 271: 47–52.
20.
Adler CH, Thorpy MJ: Sleep issues in Parkinson’s disease. Neurology 2005; 64:S12–S20.
21.
Havlikova E, van Dijk JP, Nagyova I, Rosenberger J, Middel B, Dubayova T, et al: The impact of sleep and mood disorders on quality of life in Parkinson’s disease patients. J Neurol 2011; 258: 2222–2229.
22.
Poryazova R, Oberholzer M, Baumann CR, Bassetti CL: REM sleep behavior -disorder in Parkinson’s disease: a questionnaire-based survey. J Clin Sleep Med 2013; 9: 55a–59a.
23.
Rolinski M, Szewczyk-Krolikowski K, Tomlinson PR, Nithi K, Talbot K, Ben-Shlomo Y, et al: REM sleep behaviour disorder is associated with worse quality of life and other non-motor features in early Parkinson’s disease. J Neurol Neurosurg Psychiatry 2014; 85: 560–566.
24.
Verbaan D, van Rooden SM, van Hilten JJ, Rijsman RM: Prevalence and clinical profile of restless legs syndrome in Parkinson’s disease. Mov Disord 2010; 25: 2142–2147.
25.
Moreno-Lopez C, Santamaria J, Salamero M, Del Sorbo F, Albanese A, Pellecchia MT, et al: Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study). Arch Neurol 2011; 68: 223–230.
26.
Kumar S, Bhatia M, Behari M: Excessive daytime sleepiness in Parkinson’s disease as assessed by Epworth Sleepiness Scale (ESS). Sleep Med 2003; 4: 339–342.
27.
Johns MW: Sensitivity and specificity of the multiple sleep latency test (MSLT), the maintenance of wakefulness test and the Epworth Sleepiness Scale: failure of the MSLT as a gold standard. J Sleep Res 2000; 9: 5–11.
28.
Monaca C, Duhamel A, Jacquesson JM, Ozsancak C, Destee A, Guieu JD, et al: Vigilance troubles in Parkinson’s disease: a subjective and objective polysomnographic study. Sleep Med 2006; 7: 448–453.
29.
Bolitho SJ, Naismith SL, Salahuddin P, Terpening Z, Grunstein RR, Lewis SJ: Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson’s disease. PLoS One 2013; 8: e81233.
30.
Pushpanathan ME, Loftus AM, Gasson N, Thomas MG, Timms CF, Olaithe M, et al: Beyond factor analysis: multidimensionality and the Parkinson’s disease sleep -scale-revised. PLoS One 2018; 13: e0192394.
31.
Mahale R, Yadav R, Pal PK: Quality of sleep in young onset Parkinson’s disease: any difference from older onset Parkinson’s disease. Parkinsonism Relat Disord 2015; 21: 461–464.
32.
Ferreira JJ, Desboeuf K, Galitzky M, Thalamas C, Brefel-Courbon C, Fabre N, et al. Sleep disruption, daytime somnolence and “sleep attacks” in Parkinson’s disease: a clinical survey in PD patients and age-matched healthy volunteers. Eur J Neurol 2006; 13: 209–214.
33.
Suzuki K, Miyamoto M, Miyamoto T, Tatsumoto M, Watanabe Y, Suzuki S, et al. Nocturnal disturbances and restlessness in Parkinson’s disease: using the Japanese version of the Parkinson’s disease sleep scale-2. J Neurol Sci 2012; 318: 76–81.
34.
Goldman JG, Ghode RA, Ouyang B, Bernard B, Goetz CG, Stebbins GT: Dissociations among daytime sleepiness, nighttime sleep, and cognitive status in Parkinson’s disease. Parkinsonism Relat Disord 2013; 19: 806–811.
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