Background Sleep disturbances and impairment of cognitive function are among the most frequent non-motor symptoms in Parkinson’s disease (PD) with negative implications on quality of life of patients and caregivers. Despite the fact that sleep disturbances are a major issue in PD patients, only limited data are available regarding interactions of sleep disturbances and cognitive performance. Objective This post hoc analysis of the RaSPar trial was therefore designed to further elucidate sleep disturbances and their impact on cognition in PD. Methods Twenty-six PD patients with sleep disturbances were evaluated thoroughly including assessments of patients’ subjective and objective sleep quality by interview, questionnaires, and polysomnography (PSG). Cognitive performance was assessed by Parkinson Neuropsychometric Dementia Assessment (PANDA) and Test of Attentional Performance (TAP), and associations of sleep and cognitive function were evaluated. Results We did not detect differences in cognitive performance between patients with and without rapid eye movement (REM) sleep behavior disorder (RBD). Instead, cognitive impairment, particularly affecting cognitive domains attention, executive function/working memory, and semantic memory, was associated with impaired PSG-measured sleep quality (e.g., sleep efficiency) and sleep disordered breathing (SDB) (Apnea-Hypopnea Index > 5/h). Global cognitive performance was decreased in patients with SDB (PANDA score 23.2 ± 3.5 vs. 26.9 ± 2.2, P = 0.020, unpaired two-sided t-test). Conclusion Sleep apnea and other sleep disturbances impair cognitive performance in PD and should be evaluated in routine care, and treatment options such as continuous airway pressure therapy should be considered.

中文翻译：

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睡眠障碍和睡眠呼吸障碍损害帕金森病的认知能力

背景 睡眠障碍和认知功能障碍是帕金森病 (PD) 中最常见的非运动症状之一，对患者和护理人员的生活质量有负面影响。尽管睡眠障碍是 PD 患者的一个主要问题，但关于睡眠障碍和认知表现的相互作用的数据有限。目的 因此，这项对 RaSPar 试验的事后分析旨在进一步阐明睡眠障碍及其对 PD 认知的影响。方法对26例睡眠障碍的PD患者进行全面评估，包括通过访谈、问卷调查和多导睡眠图（PSG）评估患者的主观和客观睡眠质量。通过帕金森神经心理痴呆评估（PANDA）和注意力表现测试（TAP）评估认知表现，并评估睡眠和认知功能的关联。结果 我们没有发现患有和不患有快速眼动 (REM) 睡眠行为障碍 (RBD) 的患者在认知表现方面的差异。相反，认知障碍，特别是影响认知域注意力、执行功能/工作记忆和语义记忆，与 PSG 测量的睡眠质量（例如，睡眠效率）和睡眠呼吸障碍 (SDB) 受损相关（呼吸暂停-低通气指数 > 5 /H）。SDB 患者的整体认知能力下降（PANDA 评分 23.2 ± 3.5 对 26.9 ± 2.2，P = 0.020，非配对双边 t 检验）。