Nocturnal disturbances and restlessness in Parkinson's disease: Using the Japanese version of the Parkinson's disease sleep scale-2

Apr 27, 2012Journal of the neurological sciences

Nighttime problems and restlessness in Parkinson's disease measured with a Japanese sleep scale

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Abstract

Parkinson's disease patients scored 15.0±9.7 on the Parkinson's disease sleep scale (PDSS)-2, significantly lower than the 9.1±6.6 score of control subjects (p<0.001).

The PDSS-2 demonstrated satisfactory internal consistency and reliability with a Cronbach's alpha of 0.86.
Significantly impaired scores on the Epworth Sleepiness Scale, Beck Depression Inventory-II, and Parkinson Fatigue Scale were observed in PD patients compared to controls.
The PDSS-2 total score correlated with multiple measures, including the Pittsburgh Sleep Quality Index and Parkinson's Disease Quality of Life questionnaire summary index.
Nocturnal restlessness was significantly more frequent in PD patients, while the frequency of restless legs syndrome did not differ between groups.
The Parkinson's Disease Quality of Life questionnaire summary index and Pittsburgh Sleep Quality Index were significant predictors of the PDSS-2 total score.

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OBJECTIVE: The aim of this study was to assess the validity and the reliability of the Japanese version of the Parkinson's disease sleep scale (PDSS)-2 and to use this scale to identify nocturnal symptoms and their impact on patient's quality of life.

METHODS: A cross-sectional, case-controlled study was conducted consisting of 93 patients with Parkinson's disease (PD) and 93 age- and gender-matched control subjects. The Japanese version of the PDSS-2 was used for the evaluation of nocturnal disturbances. The patient's quality of life was evaluated with the Parkinson's Disease Quality of Life questionnaire (PDQ-39) and their depressive symptoms were assessed with the Beck Depression Inventory-II (BDI-II), respectively. In addition, the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Parkinson Fatigue Scale (PFS) were administered.

RESULTS: As assessed using the PDSS-2, PD patients had significantly impaired scores compared with control subjects (15.0±9.7 vs. 9.1±6.6, p<0.001). The ESS, BDI-II and PFS scores were significantly impaired in PD patients compared with controls. A satisfactory internal consistency and test-retest reliability score were obtained for the PDSS-2 total score (Cronbach's alpha=0.86). The PDSS-2 was correlated with the PSQI, ESS, BDI-II, PFS, PDQ-39 summary index, all of the PDQ-39 domains and Unified Parkinson's Disease Rating Scale part III. The frequency of restless legs syndrome (RLS) was not significantly different between PD patients and controls (5.5% vs. 2.2%), but nocturnal restlessness was significantly more frequent in PD patients than controls. Stepwise linear regression analyses revealed the PDQ-39 summary index and the PSQI global score as significant predictors for the PDSS-2 total score.

CONCLUSIONS: Our study confirmed the usefulness of the Japanese version of the PDSS-2 that enables the comprehensive assessment of nocturnal disturbances in PD. The association between RLS and nocturnal restlessness in PD requires further study.

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Nocturnal disturbances and restlessness in Parkinson's disease: Using the Japanese version of the Parkinson's disease sleep scale-2

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