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Correlates of excessive daytime sleepiness in de novo Parkinson's disease: A case control study
Journal article   Open access   Peer reviewed

Correlates of excessive daytime sleepiness in de novo Parkinson's disease: A case control study

Tanya Simuni, Chelsea Caspell-Garcia, Christopher Coffey, Lama M Chahine, Shirley Lasch, Wolfgang H Oertel, Geert Mayer, Birgit Högl, Ron Postuma, Aleksandar Videnovic, …
Movement disorders, Vol.30(10), pp.1371-1381
09/2015
DOI: 10.1002/mds.26248
PMCID: PMC4822999
PMID: 26095202
url
http://doi.org/10.1002/mds.26248View
Open Access

Abstract

This study was undertaken to determine the frequency and correlates of excessive daytime sleepiness in de novo, untreated Parkinson's disease (PD) patients compared with the matched healthy controls. Data were obtained from the Parkinson's Progression Markers Initiative, an international study of de novo, untreated PD patients and healthy controls. At baseline, participants were assessed with a wide range of motor and nonmotor scales, including the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Excessive daytime sleepiness was assessed based on the Epworth Sleepiness scale (ESS), with a cutoff of 10. Four hundred twenty-three PD subjects and 196 healthy controls were recruited into the study. Mean ESS (min, max) score was 5.8 (0, 20) for the PD subjects and 5.6 (0, 19) for healthy controls (P = 0.54). Sixty-six (15.6%) PD subjects and 24 (12%) healthy controls had ESS of at least 10 (P = 0.28). No difference was seen in demographic characteristics, age of onset, disease duration, PD subtype, cognitive status, or utilization of sedatives between the PD sleepiness-positive versus the negative group. The sleepiness-positive group had higher MDS-UPDRS Part I and II but not III scores, and higher depression and autonomic dysfunction scores. Sleepiness was associated with a marginal reduction of A-beta (P = 0.05) but not alpha-synuclein spinal fluid levels in PD. This largest case control study demonstrates no difference in prevalence of excessive sleepiness in subjects with de novo untreated PD compared with healthy controls. The only clinical correlates of sleepiness were mood and autonomic dysfunction. Ongoing longitudinal analyses will be essential to further examine clinical and biological correlates of sleepiness in PD and specifically the role of dopaminergic therapy.
Comorbidity Humans Middle Aged Male Case-Control Studies Disorders of Excessive Somnolence - epidemiology Disorders of Excessive Somnolence - diagnosis Aged, 80 and over Parkinson Disease - diagnosis Parkinson Disease - epidemiology Adult Female Aged

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