Course And Risk Factors For Excessive Daytime Sleepiness In Parkinson’s Disease

Objective : Excessive daytime sleepiness is a common non-motor symptom in Parkinson’s disease.To describe the features of excessive daytime sleepiness(ESD)in patients with Parkinson disease(PD)and to ascertain whether it is correlated with age,sex,duration of PD,severity of motor dysfunction,dopaminergic agonists,cognitive level,emotional symptom or other factors.Methods : 112 cases of patients with PD in our patient-clinical and 120 age-matched healthy controls participated in the study.Excessive daytime sleepiness was evaluated by Epworth sleepiness scale(ESS).The severity of the disease was evaluated by Hoehn and Yahr stage(H-Y),Unified Parkinson’s disease Rating Scale-Ⅲ(UPDRS-Ⅲ),Hamilton Depression Rating Scale(HAMD),and Mini-Mental State Examination(MMSE).According to the ESS score,Parkinson were divided into EDS group(ESS≥10)and non EDS group(ESS < 10).The relationship between EDS and age,sex,duration of disease,MMSE score,UPDRS-Ⅲ,HAMD score,dopaminergic agonists was evaluated by Multi-factor logistic.To determine the possible contribution factors for EDS,multivariate logistic regression analysis were done using variables with P values<0.05 in univariate analysis.Statistical significance was established as P < 0.05 and 95% CI contains no 1.Results : 1.General informationThe study included 112 patients with PD,55.36% males(n=62),44.64% females(n=50),mean age 68.82 ±8.82 years.The control group consisted of males(n = 60)and females(n=60),mean age 66.70±10.33 years.PD group of patients there were 44 cases(39.28%)ESS ≥ 10,healthy control group had 16 cases(13.33%)ESS <10,two groups had statistically significant difference(P < 0.05).2.Related factors analysis:(1)In the EDS group female(59.09%),duration of the disease 5.06±2.65 years.In the non-EDS group female(52.94%),duration of the disease 4.71±3.53 years.There were no significant between the two groups in above parameters(p>0.05).(2)EDS group compared with Non-EDS group,there were statistical difference in age,HAMD score,Hoehn-Yahr stage,UPDRS-Ⅲ score,PSQI score,dopaminergic agonists and levodopa dose(p<0.05).(3)Multivariate logistic regression analysis showed that HAMD score(OR=1.221,95%CI1.006-1.483),dopaminergic agonists(OR=5.475,95%CI 1.094-27.398),levodopa dose(OR=1.009,95%CI 1.003-1.015)were independent risk factors of EDS.Conclusion :1.EDS are more common in patients with PD as compared with the controls.2.Many factors were possible related to it,especially HAMD score,the usage of levodopa metering application and dopaminergic agonists.3.In clinical work,caution should be taken in drug selection,especially the application of large dose of levodopa and dopamine receptor agonist,observation of excessive daytime sleepiness,to avoid danger.