Research On Clinical Features And Sleep Disturbances In Parkinson's Disease Patients With Pain

Objective: Both sleep disorders and pain in Parkinson's disease(PD)severely influence patient's quality of life.To date,little is known about the particular association between objective sleep disturbances and pain in PD population.This study aimed to 1)examine the clinical characteristics of pain in patients with PD and 2)explore the correlation between pain and sleep disturbances in PD patients.Methods: 144 PD patients with or without pain were enrolled in the study from the Second Affiliated Hospital of Soochow University and all underwent extensive clinical evaluations including motor and non-motor symptoms of PD.Clinical features of pain were particularly documented.An overnight video-polysomnography(PSG)was also conducted.Clinical manifestations and PSG parameters were compared in PD patients with(PD+pain)or without(PD-pain)pain.According to their pain types,PD+pain patients were then divided into two subgroups: musculoskeletal pain(MSP)and miscellaneous pain(MLP),and further comparisons were performed between the two subgroups.Results: 1.Pain was reported by 75(52.1%)patients,with 49(65.3%)reporting pain of at least moderate severity.2.PD+pain group had older age,longer disease duration,higher H/Y stage,higher scores for UPDRS,HRSD,PDQ-39,NMSQ,PSQI,ESS and more L-dopa equivalent daily dose compared to PD-pain group(all p < 0.05).3.PD patients with pain also showed significantly decreased sleep efficiency(57.06±15.84 vs.73.80±12.00 %,P < 0.001),increased non-rapid eye movement stage 1(N1)sleep(33.38±19.32 vs.17.84±8.48 %,P < 0.001)and decreased Rapid Eye Movement(REM)sleep(12.76±8.24 vs.16.06±6.53 %,P= 0.009).No significant differences were found between PD+pain subgroups for motor,non-motor symptoms or sleep parameters.4.Binary logistic regression analysis revealed that poorer abilities of daily living,depressed mood,higher percentage of N1 sleep,and lower sleep efficiency were independent predictors of pain in PD patients.Conclusions: 1.Pain is a frequent non-motor symptom of PD and musculoskeletal pain is the most common type of pain in PD patients.2.Disrupted sleep continuity,altered sleep architecture,depressed mood and compromised abilities of daily living may be associated with pain in PD patients.3.More attention should be paid to non-motor symptoms such as pain and sleep disturbances in PD,as intervention strategies focusing on pain or poor sleep could improve patients' quality of life.