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Nocturnal Hypokinesia and Sleep Quality in Parkinson's Disease

Authors

  • Maartje Louter MD,

    1. Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
    2. Sleep Medicine Centre Kempenhaeghe, Heeze, the Netherlands
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  • Marten Munneke PT, PhD,

    1. Department of Neurology, Nijmegen Centre for Evidence Based Practice, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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  • Bastiaan R. Bloem MD, PhD,

    1. Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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  • Sebastiaan Overeem MD, PhD

    Corresponding author
    1. Sleep Medicine Centre Kempenhaeghe, Heeze, the Netherlands
    • Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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Address correspondence to Sebastiaan Overeem, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands. E-mail: s.overeem@neuro.umcn.nl

Abstract

Objectives

To study the relationship between nocturnal hypokinesia and sleep quality in Parkinson's disease (PD).

Design

Questionnaire study using intergroup analysis.

Setting

Parkinson Centre Nijmegen, a tertiary university referral center.

Participants

Two hundred forty individuals with Parkinson's disease.

Measurements

Clinical and demographic data were obtained. Nocturnal hypokinesia was assessed using Question 35 of the Parkinson's Disease Quality of Life Questionnaire and rated on a 5-point Likert scale (1 = all of the time to 5 = never). The Pittsburgh Sleep Quality Index (PSQI) was used to quantify sleep quality, higher scores indicating poorer sleep quality.

Results

One hundred thirty-five of 240 participants had difficulties turning over in bed. Mean PSQI scores were significantly higher in participants with nocturnal hypokinesia (7.7 ± 4.1) than in those without (6.1 ± 3.4, P = .001). A regression model correcting for age, disease duration, and Hoehn and Yahr stage showed a significant influence of nocturnal hypokinesia on sleep quality (coefficient of determination = 0.042, standardized-beta = 0.163, P = .03). There was a linear relationship between frequency of nocturnal hypokinesia and sleep quality.

Conclusion

This is the first study that documents that nocturnal hypokinesia negatively affects sleep quality in PD. Nocturnal hypokinesia therefore merits therapeutic attention, including optimal nighttime dopaminergic treatment and education about turning strategies in bed.

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