Sleep apnea syndrome in Parkinson's disease. A case-control study in 49 patients

• Published in: Movement disorders Vol. 20; no. 11; pp. 1413 - 1418
• Main Authors: Diederich, Nico J., Vaillant, Michel, Leischen, Mike, Mancuso, Giovanna, Golinval, Serge, Nati, Romain, Schlesser, Marc
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.11.2005; Wiley
• Subjects: Aged; Analysis of Variance; Biological and medical sciences; Body Mass Index; Case-Control Studies; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Demography; excessive daytime sleepiness; Humans; Male; Medical sciences; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Parkinson Disease - complications; Parkinson's disease; polysomnography; Polysomnography - methods; Respiration; Retrospective Studies; sleep apnea syndrome; Sleep Arousal Disorders - classification; Sleep Arousal Disorders - etiology; Human; Sleep apnea syndrome; Nervous system diseases; Parkinson's disease; Respiratory disease; Parkinson disease; excessive daytime sleepiness; Case control study; Polysomnography; Cerebral disorder; Central nervous system disease; Degenerative disease; Extrapyramidal syndrome
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.20624

In PD, the impact of nocturnal respiration on sleep continuity and architecture has not been systematically investigated by polysomnography (PSG). We performed a case–control study with retrospective analysis of PSG data of 49 PD patients. After classifying the PD patients according to their apnea/hypopnea index (AHI), they were matched with 49 controls in terms of age, gender, and AHI. There were 21 PD patients (43%) who had sleep apnea syndrome (SAS), classified as mild (AHI, 5–15) in 10 patients, moderate (AHI, >15–30) in 4 patients, and severe (AHI, > 30) in 7 patients. PD patients had more deep sleep (P = 0.02) and more nocturnal awakenings (P < 0.001) than the controls. Their body mass index (BMI) was lower (P = 0.04), and they maintained a more favorable respiratory profile, with higher mean and minimal oxygen saturation values (P = 0.006 and 0.01, respectively). These differences were preserved when only considering PD patients with AHI > 15. PD patients had less obstructive sleep apneas (P = 0.035), independently from the factor AHI. Only the respiratory changes of 4 PD patients with BMI > 27 and AHI > 15 (8%) approximated those seen in the controls. At an early or middle stage of the disease, non‐obese PD patients frequently have AHI values suggesting SAS, however, without the oxygen desaturation profile of SAS. Longitudinal studies of patients with such “abortive” SAS are warranted to establish if this finding reflects benign nocturnal respiratory muscle dyskinesia or constitutes a precursor sign of dysautonomia in PD. © 2005 Movement Disorder Society