Clinical Study On Sleep Benefit In Parkinson’s Disease

Objective:To investigate the clinical features and related factors of sleep benefit(SB)in Parkinson’s disease(PD),and to explore the relationship between SB and cognitive dysfunction.Methods:Primary PD patients and healthy people without cognitive impairment were recruited.PD patients were divided into PD with SB(PD+SB)group and PD without SB(PD-SB)group,PD with normal cognitive function(PD-NC)group and PD with mild cognitive dysfunction(PD-MCI)group.The demographic and clinical information of all subjects were recorded,and all subjects were assessed by related scales.Results:1.PD+SB group in disease duration,duration of dopamine replacement therapy,levodopa daily equivalent dose(LEDD),excessive daytime sleepiness(EDS)ratio,and PD-MCI ratio were significantly higher than those of the PD-SB group,while the MoCA score was significantly lower than that of the PD-SB group.Multivariate logistic regression analysis showed that EDS ratio(OR = 7.498,95% confidence interval: 2.133-26.355,p = 0.002),duration of dopamine replacement therapy(OR = 1.015,95%confidence interval: 1.001-1.029,p = 0.032)were associated with sleep benefit in Parkinson’s disease.2.There was significant difference in total MoCA score,attention score,language score and abstraction score among PD-SB group,PD+SB group and HC group(p<0.05).Comparing to PD-SB group and HC group,the total MoCA score of PD-SB group was significantly lower.Attention score and abstraction score of the PD+SB group were significantly lower than those of the PD-SB group(p<0.05).The total MoCA score,attention score,language score,abstraction score,and delayed memory score of the PD+SB group were lower than those of the HC group(p<0.05).The language score of the PD-SB group was significantly lower than that of the HC group(p<0.05).There was no significant difference in other cognitive domains of MoCA.3.Comparing to PD-NC group,disease duration,duration of dopamine replacement therapy,H-Y stage,and SB ratio of PD-MCI group were significantly higher(p<0.05).The age of the PD-MCI group may be higher than that of the PD-NC group(71.36±6.14 vs 68.52±5.67,p=0.050).Multivariate logistic regression analysis showed sleep benefit(OR = 3.086,95% confidence interval: 1.048-9.187,p=0.041),disease duration(OR value= 1.014,95% confidence interval: 1.001-1.028,p=0.033)were independent risk factors for mild cognitive impairment in Parkinson’s disease.Conclusions:1.Excessive daytime sleepiness and duration of dopamine replacement therapy are independent risk factors of sleep benefit.PD patients with EDS and long drug duration of dopamine replacement therapy are more likely to experience sleep benefit.2.PD patients with sleep benefit show cognition decline,especially in the domain of attention,language,abstraction and delayed memory of MoCA.3.Sleep benefit and disease duration are risk factors of mild cognitive impairment in PD patients.