Comparison of sleep disturbance in mild versus severe parkinson's disease

Alan Young', Tom Churchward, Peter Holmes, Nick Freezer, Mal Hörne, Michael Ho

Research output: Contribution to journalArticleResearchpeer-review


Background: Sleep fragmentation and decreased REM sleep are well recognised phenomenon in Parkinson's disease. These abnormalities tend to worsen with disease progression. The factors which produce sleep disturbance include the disease itself, the treatment medications and the ageing process. Aims: To identify objective sleep parameters most influenced by the progression of Parkinson's disease, in a subgroup of patients with pathological sleepiness. Methods: Patients with Parkinson's disease and objective evidence of sleepiness ( Epworth Sleepiness Score8 ) were assigned as having mild ( Hoehn and Yahr score 1 or 2 ) or severe ( score 4 or 5 ) disease by their treating neurologist. Patients with intermediate disease ( score of 3 ) were excluded. All patients then underwent overnight polysomnography with EEC, EMG, EOG and video/ audio monitoring, which were staged using standard criteria (Rechtschaffen and Kales ). The frequency of nocturia and number of nocturnal vocalisations were also recorded. Evaluation with a quality of life, depression and sleep symptom questionnaire and cardiovascular reflex testing for autonomie dysfunction were also performed. Medication dosages, including L-dopa, were recorded. The Mann-Whitney U test was used to assess for differences between the mild and severe disease groups. Results: 11 patients with mild disease and 7 with severe disease were studied. There was a significant increase in sleep latency and frequency of nocturia in the severe disease group (p0.05 ). There was no significant statistical difference in age, L-dopa dose or % REM sleep overnight between the two groups, during the period of study. Conclusion: Initiation insomnia and nocturia are two important disease-related factors which may contribute to sleep disturbance in Parkinson's disease. The matching of age and L-dopa dose between the two groups could explain the unexpected finding that % REM sleep overnight was not related to disease severity.

Original languageEnglish
Pages (from-to)A54
Number of pages5
Issue numberSuppl. 1
Publication statusPublished - 2001
Externally publishedYes


  • Parkinson's disease
  • Sleep disturbance

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