Journal of Parkinson's diseaseJul 31, 2023

Nighttime Symptoms in Chinese Parkinson's Patients Measured by the PDSS-2 Scale

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Updated Apr 5, 2026

Abstract

Among 1,500 Chinese Parkinson's disease patients, 38.4% reported nocturnal symptoms.

Nocturnal symptoms were more prevalent in patients older than 65 years, with 59.2% in this age group.
Patients experiencing nocturnal symptoms had a higher total score on the Parkinson's disease questionnaire (PDQ-8), indicating poorer quality of life.
Moderate and severe depression were more frequently reported in patients with nocturnal symptoms, suggesting a link between these conditions.
Anxiety levels were also higher in patients with nocturnal symptoms, indicating potential co-occurrence.
Longer disease duration and more advanced were independently associated with the presence of nocturnal symptoms.
Factors such as education level, depression, disease course, Hoehn-Yahr stage, and nocturnal symptoms were found to be related to quality of life.

Simplified

BACKGROUND: Nocturnal symptoms have a significant effect on the quality of life in Parkinson's disease (PD) patients.

OBJECTIVE: This study aimed to investigate the prevalence and associated factors of nocturnal symptoms in Chinese PD patients.

METHODS: This multicenter cross-sectional study included 1,500 patients with primary PD from 18 centers in China was carried out between February 2019 and February 2020. Questionnaires including Parkinson's disease sleep scale 2 (), Parkinson's disease questionnaire 8 (PDQ-8), Beck depression inventory (BDI), and generalized anxiety disorder scale 7 (GAD-7) were used to assess nocturnal symptoms, quality of life, depression, and anxiety.

RESULTS: Among 1,500 Chinese PD patients, 576 (38.4%) reported nocturnal symptoms. Of them, 59.2% were older than 65 years. The PDQ-8 total score was higher in patients with nocturnal symptoms (p < 0.01). Moderate and severe depression was reported more often in patients with nocturnal symptoms (p < 0.01), and the occurrence and severity of anxiety were higher as well (p < 0.01). Longer disease duration and higher Hoehn-Yahr (HY) stage were independently associated with nocturnal symptoms (p < 0.01). Education level, depression, disease course, HY stage, and nocturnal symptoms were related to the quality of life in Chinese PD patients (p < 0.01).

CONCLUSION: Our study found that 38.4% of Chinese PD patients have nocturnal symptoms, even in early and mid-stage PD. Nocturnal symptoms were associated with worse quality of life and higher incidences of depression and anxiety. Nocturnal symptoms should be included in the assessment and care plan, especially in patients with longer disease courses and higher HY stages.

Key numbers

576 of 1,500

Prevalence of Nocturnal Symptoms

Patients with nocturnal symptoms out of total participants.

32.64

Quality of Life Score

PDQ-8 total score in patients with nocturnal symptoms.

59.2%

Older Patients with Nocturnal Symptoms

Percentage of patients with nocturnal symptoms aged over 65.

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Funding

Competing interests

The authors have no conflict of interest to report.

PubMed

Nighttime Symptoms in Chinese Parkinson's Patients Measured by the PDSS-2 Scale

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