Analysis Of Nocturnal Hypokinesia And Sleep Qualityin Parkinson's Disease

Part ? Quantitative evaluation of nocturnal hypokinesia of Parkinson's disease patientsObjective Nocturnal hypokinesia/akinesia is believed to be common in Parkinson's disease(PD),but is often underestimated.Nocturnal movement in PD patients and non-PD controls was assessed by multisite inertial sensor.Collected data and clinical rating scale parameters were analyzed and correlations established.Methods Participants in this study were inpatients and outpatients of the Second Affiliated Hospital of Soochow University Neurology Department and Sleep Medicine Center from March 2016 to January 2017.Motor function and disease stage assessment included UPDRS-III and Hoehn and Yahr(H-Y)staging.PD patients reporting impaired bed mobility(IBM)(PD+IBM,n=17)and those without IBM(PD-IBM,n=12)and matched non-PD controls(n=12)were monitored using multisite inertial sensors.Collected data and clinical rating scale parameters were analyzed and correlations established.Results PD+IBM patients had worse UPDRS-III Scores and UPDRS axial scores(P<0.001,P<0.001)in comparison to PD-IBM patients.Compared to PD-IBM patients and No-PD subjects,PD+IBM patients had fewer turns(P=0.020,P<0.001)and turned with smaller degree(P=0.047,P<0.001).Correlation analysis showed that nocturnal movements had inverse correlations with disease duration(r=-0.378,P=0.043)and UPDRS axial scores(r=-0.370,P=0.048)in 29 PD patients.Conclusions It is feasible to quantitatively evaluate nocturnal motor functions by utilizing multisite inertial sensors in PD patients,especially those with impaired bed mobility.The number and the degree of turning over showed greater significance than other parameters.Worse nocturnal motor functions progress along with the duration and severity of PD.The function of impaired axis movement can be manifested as turning lessand with smaller degree in PD patients.Part ? Analysis of nocturnal hypokinesia and sleep quality in Parkinson's diseaseObjectives To assess motor symptoms and sleep quality,multisite inertial sensors and polysomnography were used to accurately monitor PD patients and No-PD subjects in one night.By further correlating the recorded parameters with other characteristics in PD patients,results of our study may be helpful to guide setting of therapeutic interventions and nursing projects for PD patients.Methods Participants in this study were inpatients and outpatients of the Second Affiliated Hospital of Soochow University Neurology Department and Sleep Medicine Center from March 2016 to January 2017.Subjective sleep quality assessment include Pittsburg Sleep Quality Index(PSQI)and Epworth sleepiness scale(ESS),the Parkinson Disease Sleep Scale(PDSS)was used to assess subjective sleep quality of PD patients additionally.PD patients reporting impaired bed mobility(IBM)(PD+IBM,n=17)and those without IBM(PD-IBM,n=12)and matched non-PD controls(n=12)were monitored using multisite inertial sensors and polysomnography.Collected data and clinical rating scale parameters were analyzed among three groups.Correlations of these parameters were performed in 29 PD patients.Results Compared to PD-IBM patients,PD+IBM patients had worse Pittsburg Sleep Quality Index(PSQI)scores(P=0.011)and Parkinson Disease Sleep Scale(PDSS)scores(P=0.009).Moreover,PD+IBM patients had less total sleep time(TST)(P=0.001)and worse sleep efficiency(SE)(P=0.006)in comparison to No-PD subjects.Correlation analysis showed that sleep quality had correlations with H-Y stage,disease duration,UPDRS-? scores and UPDRS axial scores in PD patients.TST and SE had positive correlations with the number of turning in bed while PSQI and PDSS correlated with the number of getting out of bed for urination in PD patients.Multivariate linear regression analyses showed that UPDRS axial scores and the number of turns were significantly associated with TST(both P<0.05).Conclusions PD patients with longer-duration and more severe symptoms would have worse nocturnal motor functions and sleep quality.UPDRS axial scores and the number of turning-over episodes were two most significant factors affecting sleep quality in PD patients.However,it is still difficult to attribute decline in sleep quality solely to impaired bed mobility in PD patients.