AUTHOR=Sun Shuyu , Zhao Xianchao , Ren Jiafeng , Cheng Jinxiang , Zhou Junying , Su Changjun 

TITLE=Characteristics of Objective Sleep and Its Related Risk Factors Among Parkinson's Disease Patients With and Without Restless Legs Syndrome

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.644385

DOI=10.3389/fneur.2021.644385

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> This study aimed to investigate the objective sleep characteristics and their related risk factors among Parkinson's disease (PD) patients with and without restless legs syndrome (RLS).</p><p><bold>Methods:</bold> A total of 125 patients with PD who underwent overnight polysomnography (PSG) were recruited consecutively. Eighty-one patients, including 27 PD with RLS (PD-RLS) and 54 PD without RLS (PD-NRLS), were included in the final analysis after 1:2 propensity score matching. Demographic, clinical, and polysomnographic data were compared between PD patients with and without RLS. The risk factors for sleep quality were examined using a multiple linear regression model.</p><p><bold>Results:</bold> The prevalence of RLS among PD patients was 28.0% (35/125). The PD-RLS group exhibited a higher score for the Unified Parkinson Disease Rating Scale (UPDRS) III than the PD-NRLS group. Also, the PD-RLS patients displayed significantly shorter total sleep times, worse sleep quality, decreased stage 3 duration, a longer wake time after sleep onset, and a higher arousal index than those without RLS (all <italic>p</italic> &lt; 0.05). In the multiple linear regression model, PD duration (β = −0.363, 95% CI: −0.652 to −0.074; <italic>p</italic> = 0.016), UPDRS-III (β = −0.356, 95% CI: −0.641 to −0.071; <italic>p</italic> = 0.016), and periodic limb movement index (PLMI) (β = −0.472, 95% CI: −0.757 to −0.187; <italic>p</italic> = 0.002) were determined to be the risk factors influencing sleep quality in PD-RLS patients. The UPDRS-III (β = −0.347, 95% CI: −0.590 to −0.104; <italic>p</italic> = 0.006) and HAMD scores (β = −0.343, 95% CI: −0.586 to −0.100; <italic>p</italic> = 0.007) were significantly associated with sleep quality after adjusting for confounding factors in PD-NRLS patients, respectively.</p><p><bold>Conclusions:</bold> PD-RLS patients exhibited more disturbed and fragmented sleep in objective sleep architecture than PD-NRLS patients. The severity of motor symptoms in PD was significantly associated with poor sleep quality in both PD-RLS and PD-NRLS patients. Notably, our findings indicated that periodic limb movements during sleep (PLMS) was the risk factor that influenced the objective sleep quality in PD patients with RLS.</p>