RESUMO
@#Objective To investigate the relationship of sleep disorders with emotional apathy and cognitive executive function in patients with Parkinson's disease （PD）. Methods Ninety-two patients with PD （41 males and 51 females） who visited the Department of Neurology，The Affiliated Hospital of Southwest Medical University from January to December 2022 were included. All patients were scored using the Pittsburgh Sleep Quality Index （PSQI） and divided into sleep disorders group （PSQI≥8） and non-sleep disorders group （PSQI<8）. To investigate the clinical characteristics of PD patients with sleep disorders，we employed the UPDRS-Ⅱ，UPDRS-Ⅲ，UPDRS-V （H-Y staging），Epworth Sleepiness Scale （ESS），Montreal Cognitive Assessment （MOCA） scale，Mini-Mental State Examination （MMSE） scale，Stroop Color-Word Test （SCWT），Trail Making Test （TMT），and Modified Apathy Evaluation Scale （MAES） to measure the severity of PD，daytime sleepiness，emotional apathy，and cognitive executive function in all subjects. Results The PD patients with sleep disorders （64，69.6%） showed significantly higher values in age （71.88±8.77），duration of illness ［3 （1，7）］，UPDRS-Ⅱ score ［14 （9，19.5）］，UPDRS-Ⅲ score ［30.5 （19，44）］，and H-Y stage ［2.5 （2，3）］，as compared with patients without sleep disorders ｛（64.96±10.47），［1 （0.5，3.5）］，［5 （2，8）］，［9.5 （6，18）］，［1.75（1.5，2）］｝ （P<0.01）. Patients with sleep disorders also showed significantly higher values in the response time of SCWT A （84±29），B （78±30），and C ［124 （97，146）］，the time spent on TMT a ［118 （95，165）］ and b ［126 （100，168）］，and the MAES score ［16 （11，22）］，as compared with patients without sleep disorder｛（67±23），（59±22），［86 （75.5，103.5）］，［94 （76.5，115）］，［103 （83，139）］，［9.5 （7，11）］｝ （P<0.05）. The MMSE score and MoCA score were significantly lower in the sleep disorders group ｛［23 （19，27）］，［21 （16，26）］｝ than in the non-sleep disorders group ｛［28 （26，30）］，［25 （22，29）］｝ （P<0.01）. Sleep disorders in PD patients were positively correlated with age （r=0.307，P=0.003），disease duration （r=0.273，P=0.008），UPDRS-Ⅱ （r=0.558，P<0.001），UPDRS-Ⅲ （r=0.603，P<0.001），H-Y stage （r=0.463，P<0.001），response time of SCWT A （r=0.266，P=0.011），B （r=0.318，P=0.002），and C （r=0.436，P<0.001），time spent on TMT a （r=0.329，P=0.001） and b （r=0.216，P=0.038），MAES score （r=0.447，P<0.001），and ESS score （r=0.259，P=0.013），and negatively correlated with MMSE （r=-0.451，P<0.001） and MoCA score （r=-0.368，P<0.001）. Conclusion PD patients have a high incidence of sleep disorders. PD patients with sleep disorders are older and have longer disease duration and more significant impairment in daily living ability and motor ability compared with those without sleep disorders. Severe sleep disorders are associated with severe cognitive executive dysfunction，emotional apathy，and daytime sleepiness.