r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2022-27-1-62-68r-n-j-267Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSНеожиданные засыпания у пациентов с болезнью ПаркинсонаSudden-onset sleep in patients with Parkinson’s diseasehttps://orcid.org/0000-0003-2511-5560НодельМ. Р.NodelM. R.

Москва

Moscow

nodell_m@yahoo.comhttps://orcid.org/0000-0002-9228-5108ШевцоваК. В.ShevtsovaK. V.

Москва

Moscow

https://orcid.org/0000-0002-3564-6798КовровГ. В.KovrovG. V.

Москва

Moscow

https://orcid.org/0000-0002-8255-5645ЯхноН. Н.YakhnoN. N.

Москва

Moscow

Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет) Минздрава России; Российский геронтологический научно-клинический центр. Российский национальный исследовательский медицинский университет им. Н.И. Пирогова Минздрава РоссииРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University); Russian Gerontological Research and Clinical Center. N.I. Pirogov Russian National Research Medical UniversityRussian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет) Минздрава РоссииРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationКлинико-диагностический центр «Медси»РоссияClinical and diagnostic center “MEDSI”Russian Federation2022070320222716268Copyright © Нодель М.Р., Шевцова К.В., Ковров Г.В., Яхно Н.Н., 20222022Нодель М.Р., Шевцова К.В., Ковров Г.В., Яхно Н.Н.Nodel M.R., Shevtsova K.V., Kovrov G.V., Yakhno N.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/267

Неожиданные засыпания (НЗ) являются одним из проявлений дневной сонливости (ДС) при болезни Паркинсона (БП).

Цель исследования

Цель исследования: уточнение клинико-полисомнографических характеристик пациентов с НЗ на развернутых (2-й и 3-й по Hoehn–Yahr) стадиях БП.

Материал и методы

Материал и методы. Обследовано 42 пациента (18 мужчин и 24 женщин, средний возраст 66,5 ± 7,9 года, длительность БП 8,9 ± 4,6 года, стадия БП по Hoehn–Yahr 2,6 ± 0,5), получавших комбинированную дофаминергическую терапию препаратом леводопы и агонистом дофамина. У 32 пациентов имелась ДС, у 10 пациентов она отсутствовала. Применялись унифицированная шкала болезни Паркинсона, дневник оценки периода бодрствования, шкала сонливости Эпуорта, шкала оценки сна при БП, шкала оценки когнитивных нарушений при БП, опросники депрессии Бека, тревоги Спилбергера, шкала оценки апатии, тест на оценку внимания Струпа. Проведены видеополисомнография (ПСГ) ночного сна и множественный тест латенции сна (МТЛС).

Результаты

Результаты. НЗ выявлены у 69% пациентов с жалобами на ДС. У пациентов с НЗ отмечалась более короткая латенция засыпаний по данным МТЛС (8,1 ± 5,9 мин в отличие от 14,2 ± 3,9 мин у пациентов без ДС, p < 0,05). У пациентов с НЗ отмечалась большая тяжесть нарушений двигательных функций, апатии и депрессии (p < 0,05). Несмотря на более низкую самооценку ночного сна, у пациентов с НЗ не было значимых отличий по основным характеристикам ночного сна.

Заключение

Заключение. НЗ можно рассматривать как одно из проявлений более тяжелого течения БП. Снижение эффективности ночного сна и изменение его структуры не являются определяющим фактором развития НЗ.

Sudden-onset sleep (SOS) is one of the manifestations of excessive daytime sleepiness (ЕDS) in Parkinson’s disease (PD).

Aim

Aim: сlarify the clinical and polysomnographic characteristics of patients with SOS at the expanded (2 and 3 stages according to Hoehn–Yahr) stages of PD.

Material and methods

Material and methods. 42 patients (18 men and 24 women, average age 66.5 ± 7.9 years, duration of PD 8.9 ± 4.6 years, Hoehn–Yahr stage of PD 2.6 ± 0.5) who received combined dopaminergic therapy with levodopa and dopamine agonist were examined. 32 patients had ЕDS, 10 patients did not have it. The Unified Parkinson’s disease rating scale (UPDRS parts II, III in “on” state of dopaminergic medication), the diary of the assessment of the waking period, the Epworth Sleepiness Scale, the Parkinson Disease Sleep Scale I (PDSS I), the Sсales for Outcomes of Parkinsons disease-Cognition (SCOPA-Cog), the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Apathy Scale, the Stroop test. Objective sleep-wake assessment: standard nocturnal video-polysomnography (PSG), multiple sleep latency test (MSLT).

Results

Results. SOS was detected in 69% of patients with complaints of ЕDS. Patients with SOS had a shorter latency of falling asleep according to MSLT data (8.1 ± 5.9 min versus 14.2 ± 3.9 min in patients without of ЕDS, p < 0.05).Patients with SOS had a high severity of motor function disorders, apathy and depression (p < 0.05). Рatients with SOS had no significant differences in the main PSG characteristics of night sleep.

Conclusion

Conclusion. SOS can be considered as one of the manifestations of a more severe course of PD. A decrease in the effectiveness of night sleep and a change in its structure are not a determining factor in the development of SOS.

болезнь Паркинсонадневная сонливостьнеожиданные засыпанияParkinsons deseaseexcessive daytime sleepinesssleep attacksunintended sleep episodesReferencesНодель М.Р., Яхно Н.Н., Украинцева Ю.В. Гиперсомния при болезни Паркинсона. Неврологический журнал. 2014;19(6):9–16.Nodel M.R., Yakhno N.N., Ukraintseva U.V. Hypersomnia in Parkison’s disease. The Neurological Journal. 2014;19(6):9–16. (In Russ.).Tandberg E., Larsen J.P., Karlsen K. Excessive daytime sleepiness and sleep benefi in parkinson’s disease: a community-based study. Mov. Disord.1999;14(6):922–7.Tandberg E., Larsen J.P., Karlsen K. Excessive daytime sleepiness and sleep benefi in parkinson’s disease: a community-based study. Mov. Disord.1999;14(6):922–7.Frucht S., Rogers J.D., Greene P.E., Gordon M.F., Fahn S. Falling asleep at the wheel: motor vehicle mishaps in persons taking pramipexole and ropinirole. Neurology. 1999;52(9):1908–1910.Frucht S., Rogers J.D., Greene P.E., Gordon M.F., Fahn S. Falling asleep at the wheel: motor vehicle mishaps in persons taking pramipexole and ropinirole. Neurology. 1999;52(9):1908–1910.De Cock V.C., Vidailhet M., Arnulf I. Sleep disturbances in patients with parkinsonism. Nat. Clin. Pract. Neurol. 2008;4;254–66.De Cock V.C., Vidailhet M., Arnulf I. Sleep disturbances in patients with parkinsonism. Nat. Clin. Pract. Neurol. 2008;4;254–66.Ghorayeb I., Loundou A., Auquier P., Dauvilliers Y., Bioulac B., Tison F. et al. A nationwide survey of excessive daytime sleepiness in Parkinson’s disease in France. Mov. Disord. 2007;22:156772. doi: 10.1002/mds.21541Ghorayeb I., Loundou A., Auquier P., Dauvilliers Y., Bioulac B., Tison F. et al. A nationwide survey of excessive daytime sleepiness in Parkinson’s disease in France. Mov. Disord. 2007;22:156772. doi: 10.1002/mds.21541Abbott R., Ross G., White I. Excessive daytime sleepiness and subsequent development of parkinson’s disease. Neurology. 2005;65:1442–6.Abbott R., Ross G., White I. Excessive daytime sleepiness and subsequent development of parkinson’s disease. Neurology. 2005;65:1442–6.Ковальзон В.М., Завалко И.М. Нейрохимия цикла бодрствование–сон и болезнь Паркинсона. Нейрохимия. 2013;30(3):193–206.Kovalzon V.M., Zavalko I.M. Neurochemistry sleep-wake cycle–sleep and Parkinson’s disease. Neurochemistry. 2013;3:193–206. (In Russ.).Rye D.B. Two faces of Eve: dopamine modulations of wakefulness and sleep. Neurology. 2004;64:2–7.Rye D.B. Two faces of Eve: dopamine modulations of wakefulness and sleep. Neurology. 2004;64:2–7.Thobois S., Prange S., Sgambato-FaureV., Tremblay L., Broussolle Е. Imaging the Etiology of Apathy, Anxiety, and Depression in Parkinson’s Disease: Implication for Treatment. Curr. Neurol. Neurosci. Rep. 2017;17(10):76.Thobois S., Prange S., Sgambato-FaureV., Tremblay L., Broussolle Е. Imaging the Etiology of Apathy, Anxiety, and Depression in Parkinson’s Disease: Implication for Treatment. Curr. Neurol. Neurosci. Rep. 2017;17(10):76.Thannickal T.C., Lai Y.Y., Seigel J.M., Fronezek R., Overeem S., Lee S.Y. Hipocretin (orexin) cell loss in Parkinson’s disease. Brain. 2007:130:1577–95.Thannickal T.C., Lai Y.Y., Seigel J.M., Fronezek R., Overeem S., Lee S.Y. Hipocretin (orexin) cell loss in Parkinson’s disease. Brain. 2007:130:1577–95.Wienecke M., Werth E., Poryazova R., Baumann-Vogel H., Bassetti C.L., Weller M., Waldvogel D. et.al. Progressive dopamine and hypocretin defi ciencies in Parkinson’s disease: is there an impact on sleep and wakefulness? Sleep Res. 2012;21(6):710–7.Wienecke M., Werth E., Poryazova R., Baumann-Vogel H., Bassetti C.L., Weller M., Waldvogel D. et.al. Progressive dopamine and hypocretin defi ciencies in Parkinson’s disease: is there an impact on sleep and wakefulness? Sleep Res. 2012;21(6):710–7.Poryazova R., Benninger D., Waldvogel D., Bassetti C.L. Excessive daytime sleepiness in parkinson’s disease: characteristics and determinants. European Neurology. 2010;63(3):129–135.Poryazova R., Benninger D., Waldvogel D., Bassetti C.L. Excessive daytime sleepiness in parkinson’s disease: characteristics and determinants. European Neurology. 2010;63(3):129–135.Razmy A., Lang A.E., Shapiro C.M. Predictors of impaired daytime sleep and wakefulness in patients with parkinsons disease treated with ergot vsnonergot dopamine agonists. Arch. Neurol. 2004;61:97–102.Razmy A., Lang A.E., Shapiro C.M. Predictors of impaired daytime sleep and wakefulness in patients with parkinsons disease treated with ergot vsnonergot dopamine agonists. Arch. Neurol. 2004;61:97–102.Ondo W.G., Dat. Vuong K., Khan H., Atassi F., Kwak C., Jankovic J. Daytime sleepiness and other sleep disorders in parkinson’s disease. Neurology. 2001;57:1392–6.Ondo W.G., Dat. Vuong K., Khan H., Atassi F., Kwak C., Jankovic J. Daytime sleepiness and other sleep disorders in parkinson’s disease. Neurology. 2001;57:1392–6.Salawu F., Olokoba A. Excessive Daytime Sleepiness and Unintended Sleep Episodes Associated with Parkinson’s Disease. Oman. Med. J. 2015;30(1):3–10.Salawu F., Olokoba A. Excessive Daytime Sleepiness and Unintended Sleep Episodes Associated with Parkinson’s Disease. Oman. Med. J. 2015;30(1):3–10.Rye D.B. Excessive daytime sleepiness and unintended sleep in Parkinson’s disease. Curr. Neurol. Neurosci. Rep. 2006;6(2):169–76.Rye D.B. Excessive daytime sleepiness and unintended sleep in Parkinson’s disease. Curr. Neurol. Neurosci. Rep. 2006;6(2):169–76.Baumann C., Ferini-Strambi L., Waldvogel D. Parkinsonism with excessive daytime sleepiness–a narcolepsy-like disorder? J. Neurol. 2005;252(2):139–45.Baumann C., Ferini-Strambi L., Waldvogel D. Parkinsonism with excessive daytime sleepiness–a narcolepsy-like disorder? J. Neurol. 2005;252(2):139–45.Kaynak D., Kiziltan G., Kaynak H., Benbir G., Uysal O. Sleep and sleepiness in patients with Parkinson’s disease before and aftr dopaminergic treatment. European Journal of Neurology. 2005;12(3):199–207.Kaynak D., Kiziltan G., Kaynak H., Benbir G., Uysal O. Sleep and sleepiness in patients with Parkinson’s disease before and aftr dopaminergic treatment. European Journal of Neurology. 2005;12(3):199–207.Moller J.C., Unger M., Stiasny-Kolster K. Continuous sleep EEG monitoring in PD patients with and without sleep attaks. Parkinson. Relat. Disord. 2009;15:238–41.Moller J.C., Unger M., Stiasny-Kolster K. Continuous sleep EEG monitoring in PD patients with and without sleep attaks. Parkinson. Relat. Disord. 2009;15:238–41.Arnulf I., Konofal E., Merino-Andreu M., Houeto J., Mesnage V., Welter M.I. et al. Parkinson’s disease and sleepiness: an integral part of PD. Neurology. 2002;58(7):1019–24.Arnulf I., Konofal E., Merino-Andreu M., Houeto J., Mesnage V., Welter M.I. et al. Parkinson’s disease and sleepiness: an integral part of PD. Neurology. 2002;58(7):1019–24.Tomlison C.L., Stove R., Patel S. et al. Systematic review of levodopa dose equivalency. Movement disorders. 2010;8:2649–2653.Tomlison C.L., Stove R., Patel S. et al. Systematic review of levodopa dose equivalency. Movement disorders. 2010;8:2649–2653.Fahn S., Elton R.L. UPDRS Development Committee. Unifi d Parkinson’s disease rating scale. In: Fahn S., Marsden C.D., Calne D.B., Goldstein M. eds. Recent developments in Parkinson’s disease. Florham Park, N.J.: Macmillan; 1987:153–63.Fahn S., Elton R.L. UPDRS Development Committee. Unifi d Parkinson’s disease rating scale. In: Fahn S., Marsden C.D., Calne D.B., Goldstein M. eds. Recent developments in Parkinson’s disease. Florham Park, N.J.: Macmillan; 1987:153–63.Chaudhuri K.R., Pal S., Di Marco A. et al. The Parkinson’s disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson’s disease. J. Neurol. Neurosurg. Psychiatry. 2002;73(6):629–35.Chaudhuri K.R., Pal S., Di Marco A. et al. The Parkinson’s disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson’s disease. J. Neurol. Neurosurg. Psychiatry. 2002;73(6):629–35.Johns M.W. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–545.Johns M.W. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–545.Marinus J., Visser M., Martínez-Martín P., van Hilten J., Stiggelbout A.M. A short psychosocial questionnaire for patients with Parkinson’s disease: the SCOPA-PS. J. Clin. Epidemiol. 2003;56(1):61–7.Marinus J., Visser M., Martínez-Martín P., van Hilten J., Stiggelbout A.M. A short psychosocial questionnaire for patients with Parkinson’s disease: the SCOPA-PS. J. Clin. Epidemiol. 2003;56(1):61–7.Beck A.T., Steer R.A., Ball R., Ranieri W. Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. J. Pers. Assess. 1996;67(3):588–97.Beck A.T., Steer R.A., Ball R., Ranieri W. Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. J. Pers. Assess. 1996;67(3):588–97.Spielberger C.D., Gorsuch R.L., Lushene R., Vagg et al. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press, 1983.Spielberger C.D., Gorsuch R.L., Lushene R., Vagg et al. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press, 1983.Starkstein S.E., Mayberg H.S., Preziosi T.J., Andrezejewski P., Leiguarda R., Robinson R.G. Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J. Neuropsychiatry Clin. Neurosci. 1992;4(2):134–9.Starkstein S.E., Mayberg H.S., Preziosi T.J., Andrezejewski P., Leiguarda R., Robinson R.G. Reliability, validity, and clinical correlates of apathy in Parkinson’s disease. J. Neuropsychiatry Clin. Neurosci. 1992;4(2):134–9.Van der Elst W., Van Boxtel M.P., Van Breukelen G.J. et al. The Stroop color-word test: infl uence of age, sex, and education; and normative data for a large sample across the adult age range. Assessment. 2006;13(1):62–79.Van der Elst W., Van Boxtel M.P., Van Breukelen G.J. et al. The Stroop color-word test: infl uence of age, sex, and education; and normative data for a large sample across the adult age range. Assessment. 2006;13(1):62–79.Littner M.R., Kushida C., Wise M. et al. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep. 2005;28(1):113–121.Littner M.R., Kushida C., Wise M. et al. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep. 2005;28(1):113–121.Iber C., Ancoli-Israel S., Chesson A.L., Quan S.F. American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifi cations. Westchester: American Academy of Sleep Medicine; 2007.Iber C., Ancoli-Israel S., Chesson A.L., Quan S.F. American Academy of Sleep Medicine. The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifi cations. Westchester: American Academy of Sleep Medicine; 2007.Kryger M., Roth T., Dement W., editors. Principles and Practice of Sleep Medicine. 5th edition. Philadelphia: Saunders/Elsevier; 2010:1766 p.Kryger M., Roth T., Dement W., editors. Principles and Practice of Sleep Medicine. 5th edition. Philadelphia: Saunders/Elsevier; 2010:1766 p.Ковров Г.В. Методы диагностики расстройств сна. В кн.: Ковров Г.В., ред. Краткое руководство по клинической сомнологии. Москва: МЕДпресс-информ; 2018:272 c.Kovrov G.V. Methods of diagnosis of sleep disorders. In the book: Kovrov G.V., editor. A brief guide to clinical somnology. Moscow: MED press-inform; 2018:272 p. (In Russ.).Kotschet K., Johnson W., McGregor S., Kettlewell J., Kyoong A., O’Driscoll D.M. et al. Daytime sleepin Parkinson’s disease measured by episodes of immobility. Parkinsonism Relat. Disord. 2014;20(6):578–83.Kotschet K., Johnson W., McGregor S., Kettlewell J., Kyoong A., O’Driscoll D.M. et al. Daytime sleepin Parkinson’s disease measured by episodes of immobility. Parkinsonism Relat. Disord. 2014;20(6):578–83.Нодель М.Р., Яхно Н.Н. Апатия при болезни Паркинсона. Неврологический журнал. 2014;1:9–15. [Nodel M.R., Yakhno N.N. Apathy at Parkinson’s illness. Neurological Journal. 2014;1:9–15. (In Russ.)].Nodel M.R., Yakhno N.N. Apathy at Parkinson’s illness. Neurological Journal. 2014;1:9–15. (In Russ.).Chan L.G., Sim Soon Siang К. et al. The Longitudinal Impact of Excessive Daytime Somnolence on Motor and Nonmotor Symptoms of Parkinson’s Disease in a Southeast Asian Cohort J. Geriatr. Psychiatry Neurol. 2020;33(6):363–369.Chan L.G., Sim Soon Siang К. et al. The Longitudinal Impact of Excessive Daytime Somnolence on Motor and Nonmotor Symptoms of Parkinson’s Disease in a Southeast Asian Cohort J. Geriatr. Psychiatry Neurol. 2020;33(6):363–369.Амосова Н.А., Смоленцева И.Г., Гусейнова П.М., Маслюк О.А., Гаврилов Э.Л. Нарушения сна на ранней стадии болезни Паркинсона у пациентов, не принимающих противопаркинсонические препараты. Журнал неврологии и психиатрии им. C.C. Корсакова. 2016;116(6):77–81.Amosova N.A., Smolentseva I.G., Guseinova P.M., Maslyuk O.A., Gavrilov E.L. Sleep disorders in the early stage of Parkinson’s disease in untreated patients. Zh. Nevrol. Psikhiatr. im. S.S. Korsakova. 2016;116(6):77–81. (In Russ.).Нодель М.Р., Шевцова К.В., Ковров Г.В., Яхно Н.Н. Нарушения ночного сна у пациентов с дневной сонливостью при болезни Паркинсона. Неврология. Нейропсихиатрия. Психосоматика. 2018;10(4):23–29.Nodel M.R., Shevtsova K.V., Kovrov G.V., Yakhno N.N. Nighttime sleep disorders in patients with daytime sleepiness in Parkinson’s disease. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(4):23–29. (In Russ.)].Tavora D.G., de Bruin V.M., Lopes Gama R., Lopes E.M., Jorge I.F., de Bruin P.F. The nature of excessive sleepiness and sudden sleep onset in Parkinson ׳s disease. Sleep Sci. 2014;7(1):13–8.Tavora D.G., de Bruin V.M., Lopes Gama R., Lopes E.M., Jorge I.F., de Bruin P.F. The nature of excessive sleepiness and sudden sleep onset in Parkinson ׳s disease. Sleep Sci. 2014;7(1):13–8.Buskova J., Klempır J., Majerova V. et al. Sleep disturbances in untreated Parkinson’s disease. Journal of Neurology. 2011;258(12):2254–2259.Buskova J., Klempır J., Majerova V. et al. Sleep disturbances in untreated Parkinson’s disease. Journal of Neurology. 2011;258(12):2254–2259.Yong M.H., Fook-Chong S., Pavanni R., Lim L.L., Tan E.K. Case control polysomnographic studies of sleep disorders in Parkinson’s disease. PLoS ONE. 2011;6(7):e22511.Yong M.H., Fook-Chong S., Pavanni R., Lim L.L., Tan E.K. Case control polysomnographic studies of sleep disorders in Parkinson’s disease. PLoS ONE. 2011;6(7):e22511.Нодель М.Р., Яхно Н.Н., Украинцева Ю.В. Синдром нарушения поведения в фазе сна с быстрыми движениями глаз при болезни Паркинсона. Неврологический журнал. 2015;20(6):28–34.Nodel M.R., Yakhno N.N., Ukraintseva U.V. REM sleep behavior disorder in Parkison’s disease. The Neurological Journal. 2015;20(6):28–34. (In Russ.).

The authors declare that there are no conflicts of interest present.