Dyskinesia is one of the most disabling motor complications in Parkinson’s Disease (PD). Sleep is crucial to keep neural circuit homeostasis, and PD patients often suffer from sleep disturbance. However, few prospective studies have been conducted to investigate the association of sleep quality with dyskinesia in PD. The objective of the current study is to investigate the association between sleep quality and dyskinesia and build a prediction model for dyskinesia in PD. We prospectively followed a group of PD patients without dyskinesia at baseline for a maximum of 36 months. Univariable and multivariable Cox regression with stepwise variable selection was used to investigate risk factors for dyskinesia. The performance of the model was assessed by the time-dependent area under the receiver-operating characteristic curve (AUC). At the end of follow-up, 32.8% of patients developed dyskinesia. Patients with bad sleep quality had a significantly higher proportion of dyskinesia compared with those with good sleep quality (48.1% vs. 20.6%, p = 0.023). Multivariable Cox regression selected duration of PD, sleep quality, cognition, mood, and levodopa dose. Notably, high Pittsburgh sleep quality index (PSQI) score was independently associated with an increased risk of dyskinesia (HR = 2.96, 95% CI 1.05–8.35, p = 0.041). The model achieved a good discriminative ability, with the highest AUC being 0.83 at 35 months. Our results indicated that high PSQI score may increase the risk of developing dyskinesia in PD, implying that therapeutic intervention targeting improving sleep quality may be a promising approach to prevent or delay the development of dyskinesia in PD.

运动障碍是帕金森病 (PD) 中最严重的运动并发症之一。睡眠对于保持神经回路稳态至关重要，PD患者经常遭受睡眠障碍。然而，很少有前瞻性研究来调查睡眠质量与帕金森病患者运动障碍之间的关系。本研究的目的是调查睡眠质量与运动障碍之间的关联，并建立 PD 运动障碍的预测模型。我们对一组基线时没有运动障碍的 PD 患者进行了最长 36 个月的前瞻性随访。采用逐步变量选择的单变量和多变量 Cox 回归来研究运动障碍的危险因素。模型的性能通过受试者工作特征曲线（AUC）下的时间依赖性面积进行评估。随访结束时，32.8%的患者出现运动障碍。与睡眠质量良好的患者相比，睡眠质量差的患者出现运动障碍的比例显着较高（48.1% vs. 20.6%， p = 0.023）。多变量 Cox 回归选择 PD 持续时间、睡眠质量、认知、情绪和左旋多巴剂量。值得注意的是，高匹兹堡睡眠质量指数（PSQI）评分与运动障碍风险增加独立相关（HR = 2.96，95% CI 1.05–8.35， p = 0.041）。该模型取得了良好的判别能力，35个月时AUC最高为0.83。我们的结果表明，高 PSQI 评分可能会增加 PD 发生运动障碍的风险，这意味着以改善睡眠质量为目标的治疗干预可能是预防或延缓 PD 运动障碍发生的有效方法。