Victoria P Mery1, Priti Gros2, Anne-Louise Lafontaine2, Ann Robinson2, Andrea Benedetti2, R John Kimoff2, Marta Kaminska2. 1. From Clinica Alemana de Santiago (V.P.M.), Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile; and Respiratory Division & Sleep Laboratory (P.G., A.R., R.J.K., M.K.), Montreal Neurological Hospital (A.-L.L.), Departments of Medicine and Epidemiology, Biostatistics & Occupational Health (A.B.), and Respiratory Epidemiology and Clinical Research Unit, Research Institute (A.B., M.K.), McGill University Health Centre, Montreal, Canada. vmery@alemana.cl. 2. From Clinica Alemana de Santiago (V.P.M.), Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile; and Respiratory Division & Sleep Laboratory (P.G., A.R., R.J.K., M.K.), Montreal Neurological Hospital (A.-L.L.), Departments of Medicine and Epidemiology, Biostatistics & Occupational Health (A.B.), and Respiratory Epidemiology and Clinical Research Unit, Research Institute (A.B., M.K.), McGill University Health Centre, Montreal, Canada.
Abstract
OBJECTIVE: To assess the association between obstructive sleep apnea (OSA) and nonmotor symptoms (NMS), including cognitive dysfunction, in patients with Parkinson disease (PD). METHODS: Patients with idiopathic PD, recruited from a movement disorder clinic, underwent overnight polysomnography. OSA was defined as an apnea-hypopnea index (AHI) ≥15/h. PD severity was assessed using the Hoehn & Yahr (H&Y) scale and the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). NMS were assessed using the Montreal Cognitive Assessment (MoCA), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale, Apathy Scale, Beck Depression Inventory, Hospital Depression and Anxiety Scale, and PD sleep Scale. RESULTS: Sixty-seven patients (61.2% male), mean age 64.4 (SD 9.9) years and motor MDS-UPDRS 21.9 (12.6) using levodopa equivalent dose (LED) 752.4 (714.6) mg/d, were studied. OSA occurred in 47 patients (61.6%, mean AHI 27.1/h, SD 20.2/h), and NMS in 57 patients (85%). ESS and MoCA were associated with the AHI (ESS β = 0.0670, p = 0.031; MoCA β = -0.0520, p = 0.043, adjusted for age, sex, body mass index, LED, and H&Y). ESS was associated with respiratory arousals (β = 0.1015, p = 0.011) and intermittent hypoxemia (β = 0.1470, p = 0.006). MoCA was negatively associated with respiratory arousals (β = -0.0596, p = 0.049) but not intermittent hypoxemia. CONCLUSIONS: OSA is associated with sleepiness and cognitive dysfunction in PD, suggesting that OSA may be a reversible contributor to these NMS. Further studies will be required to evaluate whether OSA treatment can improve excessive sleepiness and cognitive dysfunction in PD.
OBJECTIVE: To assess the association between obstructive sleep apnea (OSA) and nonmotor symptoms (NMS), including cognitive dysfunction, in patients with Parkinson disease (PD). METHODS:Patients with idiopathic PD, recruited from a movement disorder clinic, underwent overnight polysomnography. OSA was defined as an apnea-hypopnea index (AHI) ≥15/h. PD severity was assessed using the Hoehn & Yahr (H&Y) scale and the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). NMS were assessed using the Montreal Cognitive Assessment (MoCA), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale, Apathy Scale, Beck Depression Inventory, Hospital Depression and Anxiety Scale, and PD sleep Scale. RESULTS: Sixty-seven patients (61.2% male), mean age 64.4 (SD 9.9) years and motor MDS-UPDRS 21.9 (12.6) using levodopa equivalent dose (LED) 752.4 (714.6) mg/d, were studied. OSA occurred in 47 patients (61.6%, mean AHI 27.1/h, SD 20.2/h), and NMS in 57 patients (85%). ESS and MoCA were associated with the AHI (ESS β = 0.0670, p = 0.031; MoCA β = -0.0520, p = 0.043, adjusted for age, sex, body mass index, LED, and H&Y). ESS was associated with respiratory arousals (β = 0.1015, p = 0.011) and intermittent hypoxemia (β = 0.1470, p = 0.006). MoCA was negatively associated with respiratory arousals (β = -0.0596, p = 0.049) but not intermittent hypoxemia. CONCLUSIONS: OSA is associated with sleepiness and cognitive dysfunction in PD, suggesting that OSA may be a reversible contributor to these NMS. Further studies will be required to evaluate whether OSA treatment can improve excessive sleepiness and cognitive dysfunction in PD.
Authors: Marta Kaminska; Victoria P Mery; Anne-Louise Lafontaine; Ann Robinson; Andrea Benedetti; Priti Gros; R John Kimoff Journal: J Clin Sleep Med Date: 2018-05-15 Impact factor: 4.062
Authors: Nadia Gosselin; Andrée-Ann Baril; Ricardo S Osorio; Marta Kaminska; Julie Carrier Journal: Am J Respir Crit Care Med Date: 2019-01-15 Impact factor: 21.405
Authors: John-Paul Taylor; Ian G McKeith; David J Burn; Brad F Boeve; Daniel Weintraub; Claire Bamford; Louise M Allan; Alan J Thomas; John T O'Brien Journal: Lancet Neurol Date: 2019-09-10 Impact factor: 44.182