{"title":"帕金森病患者夜间困倦的临床特征及相关因素","authors":"Xiaoling Qin, Xue Li, Gang Chen, Xu Chen, Mingyu Shi, Xue-Kui Liu, Zai-Li Li, Zai-E Xin, Dianshuai Gao","doi":"10.1155/2020/6378673","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The present study investigated the clinical features and correlates of poor nighttime sleepiness (PNS) in patients with Parkinson's disease (PD).</p><p><strong>Methods: </strong>One hundred ten patients with PD (divided into PD-PNS group and PD-nPNS group) and forty-seven controls (nPD-PNS group) were enrolled in this study. Demographic information was collected. Patients were assessed according to the unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr (H&Y) stage scale. Patients were also evaluated according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), rapid eye movement sleep behavior disorder screening questionnaire (RBD-SQ), restless leg syndrome (RLS) diagnosis, Hamilton's depression scale (HAMD), and Hamilton's anxiety scale (HAMA).</p><p><strong>Results: </strong>The prevalence of PNS was 55.45% (61/110) in patients with PD. The PD-PNS group tended to have a longer duration of disease, higher UPDRS-I and UPDRS-III scores, a higher percentage of RLS patients, and higher HAMA and HAMD scores than those of the PD-nPNS group. The PD-PNS group tended to have a higher percentage of RBD and RLS patients and higher HAMA and HAMD scores than those of the nPD-PNS group. Analysis of the PSQI components and PSQI impact factors showed that the PD-PNS group had worse subjective sleep quality (<i>χ</i> <sup>2</sup> = -2.267, <i>P</i> = 0.023), shorter sleep latency (<i>χ</i> <sup>2</sup> = -2.262, <i>P</i> = 0.024), fewer sleep medications (<i>χ</i> <sup>2</sup> = -4.170, <i>P</i> ≤ 0.001), worse daytime functioning (<i>χ</i> <sup>2</sup> = -2.347, <i>P</i> = 0.019), and an even higher prevalence of increased nocturia (<i>χ</i> <sup>2</sup> = 4.447, <i>P</i> = 0.035), nightmares (<i>χ</i> <sup>2</sup> = 7.887, <i>P</i> = 0.005), and pain (<i>χ</i> <sup>2</sup> = 9.604, <i>P</i> = 0.002) than those of the nPD-PNS group. Analysis also indicated that the PSQI global score positively correlated with BMI (<i>r</i> = 0.216, <i>P</i> < 0.05), H&Y stage (<i>r</i> = 0.223, <i>P</i> < 0.05), UPDRS-I (<i>r</i> = 0.501, <i>P</i> < 0.01), UPDRS-III (<i>r</i> = 0.425, <i>P</i> < 0.01), ESS (<i>r</i> = -0.296, <i>P</i> < 0.01), RBD (<i>r</i> = 0.227, <i>P</i> < 0.05), RLS (<i>r</i> = 0.254, <i>P</i> < 0.01), HAMA (<i>r</i> = 0.329, <i>P</i> < 0.01), and HAMD (<i>r</i> = 0.466, <i>P</i> < 0.01). In the final model, H&Y stage, RLS, UPDRS-III, and HAMD remained associated with the PQSI score (<i>P</i> ≤ 0.001, <i>P</i> ≤ 0.001, <i>P</i> = 0.049, <i>P</i> ≤ 0.001, respectively).</p><p><strong>Conclusions: </strong>Our data showed that PNS was common in patients with PD. H&Y stage, UPDRS-III, HAMD, and RLS were positively associated with PNS. Attention to the management of motor symptoms, RLS, and depression may be beneficial to nighttime sleep quality in patients with PD.</p>","PeriodicalId":19907,"journal":{"name":"Parkinson's Disease","volume":"2020 ","pages":"6378673"},"PeriodicalIF":2.1000,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6378673","citationCount":"3","resultStr":"{\"title\":\"Clinical Features and Correlates of Poor Nighttime Sleepiness in Patients with Parkinson's Disease.\",\"authors\":\"Xiaoling Qin, Xue Li, Gang Chen, Xu Chen, Mingyu Shi, Xue-Kui Liu, Zai-Li Li, Zai-E Xin, Dianshuai Gao\",\"doi\":\"10.1155/2020/6378673\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The present study investigated the clinical features and correlates of poor nighttime sleepiness (PNS) in patients with Parkinson's disease (PD).</p><p><strong>Methods: </strong>One hundred ten patients with PD (divided into PD-PNS group and PD-nPNS group) and forty-seven controls (nPD-PNS group) were enrolled in this study. Demographic information was collected. Patients were assessed according to the unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr (H&Y) stage scale. Patients were also evaluated according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), rapid eye movement sleep behavior disorder screening questionnaire (RBD-SQ), restless leg syndrome (RLS) diagnosis, Hamilton's depression scale (HAMD), and Hamilton's anxiety scale (HAMA).</p><p><strong>Results: </strong>The prevalence of PNS was 55.45% (61/110) in patients with PD. The PD-PNS group tended to have a longer duration of disease, higher UPDRS-I and UPDRS-III scores, a higher percentage of RLS patients, and higher HAMA and HAMD scores than those of the PD-nPNS group. The PD-PNS group tended to have a higher percentage of RBD and RLS patients and higher HAMA and HAMD scores than those of the nPD-PNS group. Analysis of the PSQI components and PSQI impact factors showed that the PD-PNS group had worse subjective sleep quality (<i>χ</i> <sup>2</sup> = -2.267, <i>P</i> = 0.023), shorter sleep latency (<i>χ</i> <sup>2</sup> = -2.262, <i>P</i> = 0.024), fewer sleep medications (<i>χ</i> <sup>2</sup> = -4.170, <i>P</i> ≤ 0.001), worse daytime functioning (<i>χ</i> <sup>2</sup> = -2.347, <i>P</i> = 0.019), and an even higher prevalence of increased nocturia (<i>χ</i> <sup>2</sup> = 4.447, <i>P</i> = 0.035), nightmares (<i>χ</i> <sup>2</sup> = 7.887, <i>P</i> = 0.005), and pain (<i>χ</i> <sup>2</sup> = 9.604, <i>P</i> = 0.002) than those of the nPD-PNS group. Analysis also indicated that the PSQI global score positively correlated with BMI (<i>r</i> = 0.216, <i>P</i> < 0.05), H&Y stage (<i>r</i> = 0.223, <i>P</i> < 0.05), UPDRS-I (<i>r</i> = 0.501, <i>P</i> < 0.01), UPDRS-III (<i>r</i> = 0.425, <i>P</i> < 0.01), ESS (<i>r</i> = -0.296, <i>P</i> < 0.01), RBD (<i>r</i> = 0.227, <i>P</i> < 0.05), RLS (<i>r</i> = 0.254, <i>P</i> < 0.01), HAMA (<i>r</i> = 0.329, <i>P</i> < 0.01), and HAMD (<i>r</i> = 0.466, <i>P</i> < 0.01). In the final model, H&Y stage, RLS, UPDRS-III, and HAMD remained associated with the PQSI score (<i>P</i> ≤ 0.001, <i>P</i> ≤ 0.001, <i>P</i> = 0.049, <i>P</i> ≤ 0.001, respectively).</p><p><strong>Conclusions: </strong>Our data showed that PNS was common in patients with PD. H&Y stage, UPDRS-III, HAMD, and RLS were positively associated with PNS. Attention to the management of motor symptoms, RLS, and depression may be beneficial to nighttime sleep quality in patients with PD.</p>\",\"PeriodicalId\":19907,\"journal\":{\"name\":\"Parkinson's Disease\",\"volume\":\"2020 \",\"pages\":\"6378673\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2020-09-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1155/2020/6378673\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Parkinson's Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2020/6378673\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2020/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Parkinson's Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2020/6378673","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 3
摘要
目的:探讨帕金森病(PD)患者夜间困倦(PNS)的临床特点及相关因素。方法:选取110例PD患者(分为PD- pns组和PD- npns组)和47例对照组(nPD-PNS组)作为研究对象。收集了人口统计信息。根据统一帕金森病评定量表(UPDRS)和Hoehn-Yahr (H&Y)分期量表对患者进行评估。采用匹兹堡睡眠质量指数(PSQI)、Epworth嗜睡量表(ESS)、快速眼动睡眠行为障碍筛查问卷(RBD-SQ)、不宁腿综合征(RLS)诊断、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)对患者进行评估。结果:PD患者中PNS患病率为55.45%(61/110)。与PD-nPNS组相比，PD-PNS组的疾病持续时间更长，UPDRS-I和UPDRS-III评分更高，RLS患者比例更高，HAMA和HAMD评分更高。PD-PNS组RBD和RLS患者比例高于nPD-PNS组，HAMA和HAMD评分高于nPD-PNS组。分析PSQI组件和PSQI影响因素表明,PD-PNS组更主观睡眠质量(χ2 = -2.267,P = 0.023),缩短睡眠潜伏期(χ2 = -2.262,P = 0.024),减少睡眠药物(χ2 = -4.170,P≤0.001),更糟的是白天的功能(χ2 = -2.347,P = 0.019),和一个更高的患病率增加的遗尿症(χ2 = 4.447,P = 0.035),噩梦(χ2 = 7.887,P = 0.005),和疼痛(χ2 = 9.604,P = 0.002)比nPD-PNS组。分析还表明,全球PSQI得分与BMI呈正相关(r = 0.216, P r = 0.223, P r = 0.501, P r = 0.425, P r = -0.296, P r = 0.227, P r = 0.254, P r = 0.329, P r = 0.466, P P≤0.001,P≤0.001,P = 0.049, P≤0.001,分别)。结论:我们的数据显示PNS在PD患者中很常见。H&Y分期、UPDRS-III期、HAMD、RLS与PNS呈正相关。注意对运动症状、RLS和抑郁的管理可能有利于PD患者的夜间睡眠质量。
Clinical Features and Correlates of Poor Nighttime Sleepiness in Patients with Parkinson's Disease.
Objective: The present study investigated the clinical features and correlates of poor nighttime sleepiness (PNS) in patients with Parkinson's disease (PD).
Methods: One hundred ten patients with PD (divided into PD-PNS group and PD-nPNS group) and forty-seven controls (nPD-PNS group) were enrolled in this study. Demographic information was collected. Patients were assessed according to the unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr (H&Y) stage scale. Patients were also evaluated according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), rapid eye movement sleep behavior disorder screening questionnaire (RBD-SQ), restless leg syndrome (RLS) diagnosis, Hamilton's depression scale (HAMD), and Hamilton's anxiety scale (HAMA).
Results: The prevalence of PNS was 55.45% (61/110) in patients with PD. The PD-PNS group tended to have a longer duration of disease, higher UPDRS-I and UPDRS-III scores, a higher percentage of RLS patients, and higher HAMA and HAMD scores than those of the PD-nPNS group. The PD-PNS group tended to have a higher percentage of RBD and RLS patients and higher HAMA and HAMD scores than those of the nPD-PNS group. Analysis of the PSQI components and PSQI impact factors showed that the PD-PNS group had worse subjective sleep quality (χ2 = -2.267, P = 0.023), shorter sleep latency (χ2 = -2.262, P = 0.024), fewer sleep medications (χ2 = -4.170, P ≤ 0.001), worse daytime functioning (χ2 = -2.347, P = 0.019), and an even higher prevalence of increased nocturia (χ2 = 4.447, P = 0.035), nightmares (χ2 = 7.887, P = 0.005), and pain (χ2 = 9.604, P = 0.002) than those of the nPD-PNS group. Analysis also indicated that the PSQI global score positively correlated with BMI (r = 0.216, P < 0.05), H&Y stage (r = 0.223, P < 0.05), UPDRS-I (r = 0.501, P < 0.01), UPDRS-III (r = 0.425, P < 0.01), ESS (r = -0.296, P < 0.01), RBD (r = 0.227, P < 0.05), RLS (r = 0.254, P < 0.01), HAMA (r = 0.329, P < 0.01), and HAMD (r = 0.466, P < 0.01). In the final model, H&Y stage, RLS, UPDRS-III, and HAMD remained associated with the PQSI score (P ≤ 0.001, P ≤ 0.001, P = 0.049, P ≤ 0.001, respectively).
Conclusions: Our data showed that PNS was common in patients with PD. H&Y stage, UPDRS-III, HAMD, and RLS were positively associated with PNS. Attention to the management of motor symptoms, RLS, and depression may be beneficial to nighttime sleep quality in patients with PD.
期刊介绍：
Parkinson’s Disease is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the epidemiology, etiology, pathogenesis, genetics, cellular, molecular and neurophysiology, as well as the diagnosis and treatment of Parkinson’s disease.
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