SUBJECTIVE SLEEP DISTURBANCES IN EARLY-ON SET PARKINSONS-DISEASE

Assessment of sleep disturbances in Parkinson's disease patients (PD) can be difficult, as sleep complaints are common in the healthy elderl y population. To differentiate PD-related sleep disorders from those r elated to normal aging, we studied sleeping problems in 31 PD patients (mean age 44.6 +/- 10.0 years) who had onset of PD before the age of 46 (mean age of PD onset 33.3 +/- 8.4 years). Thirty healthy subjects (mean age 46.0 +/- 12.5 years) served as reference group (RC). All sub jects answered standardised questions concerning sleep complaints and disorders of the autonomic nervous system, on their medical histories and on the DS self-assessment depression scale. PD patients scored on average of 3.2 +/- 1.3 in subjective rating of overall sleep quality o n a scale from 1 (best) to 6 (worst). This is significantly higher tha n the mean score of 1.8 +/- 0.8 (p less than or equal to 0.001) in the RG. The PD group complained significantly more often about difficulti es in falling asleep and maintaining sleep, about symptoms of the Rest less Legs Syndrome (RLS), about daytime sleepiness and nocturia. Poor sleep quality was related to difficulties in falling asleep but not in maintaining sleep, neither to nocturnal akinesia nor to symptoms of s leep-related breathing disturbances. In PD patients both difficulties of falling asleep and maintaining sleep correlated with nocturnal akin esia and RLS, but not with nocturia. The only interaction found in the RC was between difficulties in falling asleep and depression.