Sleep quality, excessive daytime sleepiness, and depression in Parkinson's disease: implications for improved patient outcomes.

OBJECTIVES: Sleep disorders are frequently encountered non-motor symptoms that significantly impact the lifestyle quality of individuals with Parkinson's disease (PD). Our research endeavors to research the sleep quality of PD patients and define the occurrence of excessive daytime sleepiness (EDS) and nocturnal difficulties within this population. METHODS: We incorporated 140 patients diagnosed with PD and 75 healthy individuals as controls. The modified Hoehn & Yahr Staging Scale (HYS) was employed for the clinical classification of PD stages, while the evaluation of clinical intensity utilized the Unified Parkinson's Disease Rating Scale (UPDRS). The assessment of sleep quality utilized the Pittsburgh Sleep Quality Index (PSQI), along with the Parkinson's Disease Sleep Scale (PDSS), and the Epworth Sleepiness Scale (ESS). Additionally, the subjective depression levels of attendees were assessed by the Beck Depression Inventory. RESULTS: In contrast to the healthy controls, the patient cohort demonstrated notably higher scores across the PSQI scale, ESS, and Beck Depression Scale (p < 0.05). Within the PD patient group, 66.4% exhibited poor sleep quality, and 17.1% reported excessive daytime sleepiness. A significant positive correlation was between poor sleep quality and factors such as H&Y stage, duration of levodopa exposure, scores on the ESS, and the BDI (p < 0.05). Additionally, EDS was positively correlated with UPDRS-I scores, Levodopa equivalent daily dose, PSQI, and BDI scores (p < 0.05). DISCUSSION: Addressing the specific etiology of sleep disorders in Parkinson's patients has the potential to result in improved treatment outcomes and enhanced functionality in their daily lives.

Mild cognitive impairment in patients with Parkinson´s disease and the analysis of associated factors.

OBJECTIVES: This research targeted to understand the impact of clinical findings, non-motor symptoms, white matter hyperintensities (WMHs), and metabolic features on cognition in Parkinson's disease patients with mild cognitive impairment (PD-MCI). METHODS: Sixty-one PD patients sundered into two groups: PD-MCI and normal cognition (PD-NC). We assessed cognition using Montreal Cognitive Assessment-TR (MoCA-TR) and Frontal Assessment Battery (FAB). We used the modified Hoehn&Yahr staging scale (mH&Y), Unified Parkinson's Disease Rating Scale (UPDRS), Freezing of Gait questionnaire, Beck Depression Inventory, Parkinson's disease sleep scale-2, Pittsburgh sleep quality index, Epworth sleepiness scale, and Non-motor symptoms questionnaire to evaluate all patients. We used the Fazekas scale to evaluate the WMHs and also investigated all laboratory parameters affecting cognitive functions. RESULTS: Duration of disease, UPDRS-Motor part, age, disease stage, and daytime sleepiness were dramatically higher in the PD-MCI group than in PD-NC (p < 0.05). WMHs and homocysteine were higher in the PD-MCI group than in the controls (p = 0.016 and p < 0.001, respectively). There was a negative correlation between cognition and duration of disease, age, disease stage, UPDRS-Motor scale, daytime drowsiness, WMHs and homocysteine levels. Homocysteine was negatively related to visuospatial/executive functions (r=-0.303, p = 0.021). WMHs were correlated with global cognition (p =.000 r = .-542), language (p = .001, r = -.434), and delayed recall (p = .011, r = -.332). DISCUSSION: Mild cognitive impairment is a widespread clinical situation of PD patients and often presents before the motor symptoms. Revealing curable causes that affect cognition before the development of PD-related dementia is crucial in controlling motor findings and reducing the burden of the caretakers.