Excessive daytime sleepiness and gait disturbances in patients with Parkinson's disease.

Background: Excessive daytime sleepiness (EDS), which is common in Parkinson's disease (PD), has been reported to exacerbate gait disturbance in patients with PD, but there is a lack of objective assessment, as well as an unknown specific mechanism. The purpose of our study is to explore the relationship between EDS and gait parameters.

Methods: Sixty-one patients with PD were recruited and divided into the EDS group (n = 29) and the non-EDS group (n = 32) based on the scores of the Epworth Sleepiness Scale (ESS). The gait metrics of the two groups were then assessed by wearable devices and compared under various walking scenarios.

Results: Compared with the non-EDS group, the EDS group showed significantly shorter step lengths and stride lengths, slower walk speed and gait speed, reduced shank-max forward swing and sagittal angular velocity, and increased phase coordination indices and mean duration of turns. Pearson correlation analysis revealed a significant association between ESS scores and various gait parameters. Furthermore, multiple linear regression analysis confirmed that EDS is an independent factor influencing gait in patients with PD.

Conclusion: EDS was independently associated with gait disturbances in patients with PD, suggesting that EDS symptoms warrant serious attention in clinical practice.