Objective. The present study investigated the clinical features and correlates of poor nighttime sleepiness (PNS) in patients with Parkinson’s disease (PD). Methods. One hundred ten patients with PD (divided into PD-PNS group and PD-nPNS group) and forty-seven controls (nPD-PNS group) were enrolled in this study. Demographic information was collected. Patients were assessed according to the unified Parkinson’s disease rating scale (UPDRS) and Hoehn–Yahr (H&Y) stage scale. Patients were also evaluated according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), rapid eye movement sleep behavior disorder screening questionnaire (RBD-SQ), restless leg syndrome (RLS) diagnosis, Hamilton’s depression scale (HAMD), and Hamilton’s anxiety scale (HAMA). Results. The prevalence of PNS was 55.45% (61/110) in patients with PD. The PD-PNS group tended to have a longer duration of disease, higher UPDRS-I and UPDRS-III scores, a higher percentage of RLS patients, and higher HAMA and HAMD scores than those of the PD-nPNS group. The PD-PNS group tended to have a higher percentage of RBD and RLS patients and higher HAMA and HAMD scores than those of the nPD-PNS group. Analysis of the PSQI components and PSQI impact factors showed that the PD-PNS group had worse subjective sleep quality (χ² = −2.267,  = 0.023), shorter sleep latency (χ² = −2.262,  = 0.024), fewer sleep medications (χ² = −4.170,  ≤ 0.001), worse daytime functioning (χ² = −2.347,  = 0.019), and an even higher prevalence of increased nocturia (χ² = 4.447,  = 0.035), nightmares (χ² = 7.887,  = 0.005), and pain (χ² = 9.604,  = 0.002) than those of the nPD-PNS group. Analysis also indicated that the PSQI global score positively correlated with BMI (r = 0.216,  < 0.05), H&Y stage (r = 0.223,  < 0.05), UPDRS-I (r = 0.501,  < 0.01), UPDRS-III (r = 0.425,  < 0.01), ESS (r = −0.296,  < 0.01), RBD (r = 0.227,  < 0.05), RLS (r = 0.254,  < 0.01), HAMA (r = 0.329,  < 0.01), and HAMD (r = 0.466,  < 0.01). In the final model, H&Y stage, RLS, UPDRS-III, and HAMD remained associated with the PQSI score ( ≤ 0.001,  ≤ 0.001,  = 0.049,  ≤ 0.001, respectively). Conclusions. Our data showed that PNS was common in patients with PD. H&Y stage, UPDRS-III, HAMD, and RLS were positively associated with PNS. Attention to the management of motor symptoms, RLS, and depression may be beneficial to nighttime sleep quality in patients with PD.

中文翻译：

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帕金森病患者夜间嗜睡不良的临床特征及相关性

客观。本研究调查了帕金森病 (PD) 患者夜间嗜睡不良 (PNS) 的临床特征和相关性。方法。本研究招募了 110 名 PD 患者（分为 PD-PNS 组和 PD-nPNS 组）和 47 名对照（nPD-PNS 组）。收集了人口统计信息。根据统一的帕金森病评定量表 (UPDRS) 和 Hoehn-Yahr (H&Y) 分期量表对患者进行评估。还根据匹兹堡睡眠质量指数（PSQI）、爱华嗜睡量表（ESS）、快速眼动睡眠行为障碍筛查问卷（RBD-SQ）、不宁腿综合征（RLS）诊断、汉密尔顿抑郁量表（HAMD）对患者进行评估, 和汉密尔顿的焦虑量表 (HAMA)。结果. PD 患者中 PNS 的患病率为 55.45% (61/110)。与 PD-nPNS 组相比，PD-PNS 组的病程更长，UPDRS-I 和 UPDRS-III 评分更高，RLS 患者比例更高，HAMA 和 HAMD 评分更高。与 nPD-PNS 组相比，PD-PNS 组的 RBD 和 RLS 患者比例更高，HAMA 和 HAMD 评分更高。对 PSQI 成分和 PSQI 影响因素的分析表明，PD-PNS 组主观睡眠质量较差（χ ²  = -2.267， = 0.023），睡眠潜伏期更短（χ ²  = -2.262， = 0.024），睡眠药物更少（χ ²  = -4.170,  ≤ 0.001)，日间功能更差 ( χ²  = -2.347,  = 0.019)，夜尿增多 ( χ2  = 4.447,  = 0.035)、噩梦 ( ^{χ2 = 7.887}  ,  = 0.005) 和疼痛 ( ^χ2 = 9.604  ,  = 0.002)的发生率甚至更高nPD-PNS 组的那些。分析还表明，PSQI 整体评分与 BMI ( r  = 0.216,  < 0.05)、H&Y 分期 ( r  = 0.223,  < 0.05)、UPDRS-I ( r  = 0.501,  < 0.01)、UPDRS-III ( r  = 0.425,  < 0.01), ESS ( r  = -0.296,  < 0.01), RBD ( r  = 0.227, < 0.05)、RLS ( r  = 0.254,  < 0.01)、HAMA ( r  = 0.329,  < 0.01) 和 HAMD ( r  = 0.466,  < 0.01)。在最终模型中，H&Y 阶段、RLS、UPDRS-III 和 HAMD 仍然与 PQSI 评分相关（分别 为 ≤ 0.001、 ≤ 0.001、 = 0.049、 ≤ 0.001）。结论。我们的数据显示 PNS 在 PD 患者中很常见。H&Y 分期、UPDRS-III、HAMD 和 RLS 与 PNS 呈正相关。注意运动症状、RLS 和抑郁症的管理可能有益于 PD 患者的夜间睡眠质量。