Gender Differences In Sleep Quality In Parkinson’s Disease

Objective Sleep disturbance is one of the most common non-motor symptoms of Parkinson’s disease and can seriously affect the quality of life of patients.Previous studies have found gender differences in sleep disturbance and other non-motor symptoms in patients with Parkinson’s disease,but there are few and controversial studies on gender differences in sleep quality in Parkinson’s disease.The purpose of this study was to explore gender differences in sleep quality in patients with Parkinson’s disease(PD).Methods A total of 112 patients with clinically confirmed or clinically possible PD who were admitted to Peking University Shenzhen Hospital were included,including 71 males and 41 females.All patients were evaluated with the Pittsburgh Sleep Quality Index(PSQI),Epworth Sleep Scale(ESS)and Parkinson’s Disease Sleep Scale(PDSS).Clinical data of all patients with Parkinson’s disease,such as age,age of onset,course of disease,years of education,etc.,were recorded,and the patients were asked whether they had insomnia and nightmares.PD patients were divided into two groups,male and female,the demographic data of all PD patients were analyzed,and the differences in sleep scale scores between the two groups were compared.The scores of sleep scale were used as the dependent variable,and the duration of disease,years of education,UPDRS-III score,MMSE,MOCA,HAMA,HAMD score and HY stage were used as the independent variables for correlation analysis.Results The scores of PSQI in females were significantly higher than those in males(P<0.05),and the scores of sleep continuity,habitual sleep efficiency and daytime dysfunction in females were significantly higher than those in males(P<0.05).The scores of PDSS in females were significantly lower than those in males(P<0.05),and the scores of maintenance insomnia,sad dreams,nocturnal cramps,limb pain,restless leg(RLS),hallucination,leg numbness/tingling were significantly lower than those in males.The scores of nocturnal restlessness and nocturia in males were significantly lower than those in females.ESS score in females was significantly higher than that in males(P<0.05),and the proportion of > 10 in females was significantly higher than that in males(P<0.05).Correlation analysis,the global PSQI score was negatively correlated with years of education,MMSE score(r=-0.400,-0.312),and positively correlated with UPDRS-III,HAMA,HAMD score,and HY staging(r=0.489,0.423,0.464,0.563).The global ESS score was negatively correlated with years of education(r=-0.360),and positively correlated with UPDRS-III,MOCA,HY stage,and HAMD(r=0.529,0.412,0.561,0.236).The total PDSS score was negatively correlated with UPDRS-III and HY staging(r=-0.269,-0.279).The female PSQI scores and duration,UPDRS score HY stage III,HAMD,HAMA were positively correlated(r=0.402,0.651,0.649,0.669,0.526),and negatively correlated with MMSE score(r=0.599).ESS score was positively correlated with course of disease,UPDRS-III,MOCA and HY stage(r=0.391,0.508,0.565,0.701).In women,PDSS score was negatively correlated with disease duration,UPDRS-III,MOCA and HY stage(r=-0.400,-0.627,-0.520,-0.718).Conclusion Female PD patients have a higher incidence of sleep disturbance,mainly manifested as insomnia symptoms,daytime dysfunction,nocturnal psychiatric symptoms(dreams,hallucinations),limb paresthesia(numbness,pain)and RLS.Male PD patients with nocturia and RBD problems are more prominent.