Ayumi Tsuru1, Kentaro Matsui2, Ayano Kimura3, Takuya Yoshiike4, Rei Otsuki5, Kentaro Nagao4, Megumi Hazumi4, Tomohiro Utsumi6, Michio Fukumizu7, Yohei Mukai8, Yuji Takahashi8, Takashi Sakamoto8, Kenichi Kuriyama4. 1. Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan. 2. Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan; Department of Psychiatry, Tokyo Women's Medical University, 8-1, Kawada, Shinjuku, Tokyo, 162-8666, Japan. Electronic address: matsui.kentaro@ncnp.go.jp. 3. Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan. 4. Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan. 5. Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan; Department of Psychiatry, Nihon University School of Medicine, 1-6, Kandasurugadai, Chiyoda, Tokyo, 101-8309, Japan. 6. Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan; Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan. 7. Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan; Segawa Memorial Neurological Clinic for Children, Segawa Building F2, 2-8, Kandasurugadai, Chiyoda, Tokyo, 101-0062, Japan. 8. Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
Abstract
INTRODUCTION: Comorbid insomnia and poor sleep quality in Parkinson's disease (PD) are associated with a poor health-related quality of life (HRQoL). However, the relationship between HRQoL and sleep measures obtained using polysomnography (PSG) remains unclear. We aimed to examine the association between various sleep measures and HRQoL in PD patients. METHODS: We retrospectively included patients with PD who underwent PSG and responded to self-administered questionnaires including the Pittsburgh Sleep Quality Index (PSQI) and Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: The patients' (n = 120) mean age was 67.06 (SD = 8.77) years, and their mean Hoehn and Yahr stage was 2.25 (SD = 0.78). A higher PSQI score (worse subjective sleep quality) was correlated in PSG with shorter sleep latency, less N1 sleep, and more N2 sleep. Multiple regression analysis showed that the total PSQI score correlated with both physical and mental HRQoL (p < 0.001 in both cases). However, neither type of HRQoL studied correlated with objective sleep measures, including indicators of sleep architecture, sleep-disordered breathing, and sleep related movement disorders. CONCLUSION: Despite the association between subjective sleep quality and HRQoL, the associations between objective measures and HRQoL were negligible. Objective sleep fragmentation may not be perceived as a sleep disturbance in patients with PD, and therefore may not adversely affect their subjective health, given the paradoxical correlation between PSQI score and sleep architecture.
INTRODUCTION: Comorbid insomnia and poor sleep quality in Parkinson's disease (PD) are associated with a poor health-related quality of life (HRQoL). However, the relationship between HRQoL and sleep measures obtained using polysomnography (PSG) remains unclear. We aimed to examine the association between various sleep measures and HRQoL in PD patients. METHODS: We retrospectively included patients with PD who underwent PSG and responded to self-administered questionnaires including the Pittsburgh Sleep Quality Index (PSQI) and Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: The patients' (n = 120) mean age was 67.06 (SD = 8.77) years, and their mean Hoehn and Yahr stage was 2.25 (SD = 0.78). A higher PSQI score (worse subjective sleep quality) was correlated in PSG with shorter sleep latency, less N1 sleep, and more N2 sleep. Multiple regression analysis showed that the total PSQI score correlated with both physical and mental HRQoL (p < 0.001 in both cases). However, neither type of HRQoL studied correlated with objective sleep measures, including indicators of sleep architecture, sleep-disordered breathing, and sleep related movement disorders. CONCLUSION: Despite the association between subjective sleep quality and HRQoL, the associations between objective measures and HRQoL were negligible. Objective sleep fragmentation may not be perceived as a sleep disturbance in patients with PD, and therefore may not adversely affect their subjective health, given the paradoxical correlation between PSQI score and sleep architecture.