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Progression of sleep disturbances in Parkinson’s Disease. A 5-year longitudinal study.

Lookup NU author(s): Dr Kirstie Anderson, Dr Rachael LawsonORCiD, Professor David BrooksORCiD, Professor Nicola PaveseORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


BACKGROUND: Sleep disorders can occur in early Parkinson’s disease (PD). However, the relationship between different sleep disturbances and their longitudinal evolution has not been fully explored. OBJECTIVE: To describe the frequency, coexistence and longitudinal change in excessive daytime sleepiness (EDS), insomnia and probable REM sleep behaviour disorder (pRBD) in early PD. METHODS: Data were obtained from the Parkinson’s Progression Markers Initiative (PPMI). EDS, insomnia, and pRBD were defined using the Epworth Sleepiness Scale, MDS-UPDRS Part I sub-item 1.7, and RBD screening questionnaire. RESULTS: 218 PD subjects and 102 controls completed five years of follow up. At baseline, 69 (31.7%) PD subjects reported one type of sleep disturbance, 25 (11.5%) reported two types of sleep disturbances, and three (1.4%) reported all three types of sleep disturbances. At five years, the number of PD subjects reporting one, two and three types of sleep disturbances was 85 (39.0%), 51 (23.4%), and 16 (7.3%), respectively. Only 41(18.8%) patients were taking sleep medications. The largest increase in frequency was seen in insomnia (44.5%), followed by EDS (32.1%) and pRBD (31.2%). Insomnia was the most common sleep problem at any time over the 5-year follow-up. The frequency of sleep disturbances in HCs remained stable. CONCLUSIONS: There is a progressive increase in the frequency of sleep disturbances in PD, with the number of subjects reporting multiple sleep disturbances increasing over time. Relatively few patients reported multiple sleep disturbances, suggesting that they can have different pathogenesis. A large number of patients were not treated for their sleep disturbances.

Publication metadata

Author(s): Xu Z, Anderson KN, Saffari SE, Lawson RA, Chaudhuri KR, Brooks David, Pavese N

Publication type: Article

Publication status: Published

Journal: Journal of Neurology

Year: 2021

Volume: 268

Pages: 312-320

Print publication date: 01/01/2021

Online publication date: 17/08/2020

Acceptance date: 04/08/2020

Date deposited: 20/08/2020

ISSN (print): 0340-5354

ISSN (electronic): 1432-1459

Publisher: Springer Medizin


DOI: 10.1007/s00415-020-10140-x


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Funder referenceFunder name
Britania Pharmaceuticals
Horizon 2020
Kirby Laing Foundation
Parkinson's UK