Sudden-onset sleep in patients with Parkinson’s disease

Abstract

Sudden-onset sleep (SOS) is one of the manifestations of excessive daytime sleepiness (ЕDS) in Parkinson’s disease (PD).Aim: сlarify the clinical and polysomnographic characteristics of patients with SOS at the expanded (2 and 3 stages according to Hoehn–Yahr) stages of PD.Material and methods. 42 patients (18 men and 24 women, average age 66.5 ± 7.9 years, duration of PD 8.9 ± 4.6 years, Hoehn–Yahr stage of PD 2.6 ± 0.5) who received combined dopaminergic therapy with levodopa and dopamine agonist were examined. 32 patients had ЕDS, 10 patients did not have it. The Unified Parkinson’s disease rating scale (UPDRS parts II, III in “on” state of dopaminergic medication), the diary of the assessment of the waking period, the Epworth Sleepiness Scale, the Parkinson Disease Sleep Scale I (PDSS I), the Sсales for Outcomes of Parkinsons disease-Cognition (SCOPA-Cog), the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Apathy Scale, the Stroop test. Objective sleep-wake assessment: standard nocturnal video-polysomnography (PSG), multiple sleep latency test (MSLT).Results. SOS was detected in 69% of patients with complaints of ЕDS. Patients with SOS had a shorter latency of falling asleep according to MSLT data (8.1 ± 5.9 min versus 14.2 ± 3.9 min in patients without of ЕDS, p < 0.05).Patients with SOS had a high severity of motor function disorders, apathy and depression (p < 0.05). Рatients with SOS had no significant differences in the main PSG characteristics of night sleep.Conclusion. SOS can be considered as one of the manifestations of a more severe course of PD. A decrease in the effectiveness of night sleep and a change in its structure are not a determining factor in the development of SOS.