Analysis Of Related Factors Of Sleep Disorders In Patients With Parkinson’s Disease

objective: Inquiring into the correlated factors and its interrelated degree in stimulating sleep behavior disorder in Parkinson’s disease(PD)patients.Based on the inquiry,assessing its impact on Activity of Daily Life(ADL)and quality of life(Qo L).Relying on those investigations,making a guidance to instruct whole-process management and behavioral intervention.Methods: 1.We have selected 102 typical PD patients for study,conducted in class A Tertiary Hospital in Sichuan province from December 2015 to 2016.After removing the extreme values,96 valid questionnaires were available.2.The study utilized the self-designed General Condition Questionnaires,Modified Hoehn-Yahr Staging and Unified Parkinson’s Disease Rating Scale(UPDRS)to collect patients’ demographic information(including gender,age,education level,disease onset and so on),and evaluate the disease course and its severity,Among them,the age of onset is divided into early,middle and late;H-Y classification is divided into: early and late;took the scale of outcomes in PD for autonomic symptom(SCOPA-OUT),The Hamilton anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Mini-metal state examination(MMSE),the Montreal Cognitive Assessment Scale(Mo CA),the Fatigue Scale(FS-14)and The King Parkinson’s Disease Pain Scale to assess patients’ non-motor features,such as autonomic nervous function,cognitive function,emotional state and so on;applied the Pittsburgh sleep quality index(PSQI),the Epworth Sleeping Scale(ESS)and the REM sleep behavior disorder screening questinnaire(RBDSQ)to assess the quality of sleep,daytime sleepiness,and whether or not to merge RBD;employed Activity of daily living scale(ADL),and PD 39-item Parkinson Disease Quality of Life Questionnaire(PDQ39)to assess capacity of daily life and quality of life.3.According to the score of PSQI above or equal to 7,96 patients were divided into sleep disorder(SD)group and non-sleep disorder(NSD)group.We compared two group differences respectively.Utilizing the forward method of Wald testified those differences.We then added Logistic regression analysis to determine the degree of correlation between relevant factors.Disease related data were collected through Excel.Statistical analysis was operated in SPSS17.0 software.Specifically,quantitative data was done by t test or rank sum test,and X2 analysis was used to count data.Worthy to name,P<0.05 for the difference was the significant factor.Results: Of 96 patients participating the study,the ratio of male to female was 1.82: 1;PSQI score between 2 and 19 minutes,67 in sleep disorder(SD)group and 29 in non-sleep disorder(NSD)group.The incidence of sleep disorder was 69.79%.The data were analyzed by normal test(partial data after normal conversion),except for MMSE,King Parkinson’s pain scale and FS-14 score were skewed distribution data,the rest of the data were normal distribution.Compared with two group statistical analysis,there is no notable statistical deviation in demographic information,including gender(X2=0.349),age(t=-1.058),age of onset(X2 = 0.715),education level(X2=3.871)and SQRT(duration)(t =-0.712));There were significant differences in UPDRSⅢ score(t =-2.48)and exercise symptom type(X2 = 6.416)between the two groups.There was no difference in H-Y grade(X2b = 0.211)between the two groups.There were significant differences in ESS(X2 = 0.206),RBDSQ(X2b = 4.743),HAMA(t’=-3.925),SQRT(HAMD)(t =-3.187),UPDRSI(t =-3.081),SCOPA-AUT(t =-2.167),MMSE(z =-3.1611),Mo CA(t =-2.201),FS-14(z =-2.956),King Parkinson’s Pain Scale(z =-2.091).The ADL(t =-2.088),PDQ-39(t’=-2.464)and UPDRSⅡ(t =-2.094)were significantly different between the two groups.Meanwhile,we found the difference in analyzing the equivalent dose of drug(t =-2.219)and after treatment complications UPDR Ⅳ(t’=-3.813),prompting drugs were possibly one of factors causing the SD symptom in PD patients.Therefore,through the progressive multivariate logistic regression analysis,the primary factors were HAMA and MMSE scores.The regression equation is logit(p)= 3.598-0.157 × MMSE + 0.086 × HAMA.The accuracy of the model is 72.9%,Hosmer and Lemeshow goodness test X2 = 5.157,P> 0.05.Analyzed by ROC curve,the area below the curve is 0.751.Thus,the fitted data and accuracy of prediction provided by the model is good.Conclusion: Anxiety status and cognitive dysfunction in PD patients are critical factors inducing SD,which might seriously affect the patients’ ADL and Qo L.In order to create a pleasant living condition for patients,taking actions on prevention and advanced drug and behavioral intervention could possibly reducing the SD incidence in PD patients and elevate ton Patients’ Qo L.