Association among fatigue, sleep disorders and other clinical parameters in Parkinson’s disease

• Published in: European journal of public health 2020-06, Vol.30 (Supplement_2)
• Main Authors: Asano, A, Asano, N, Mota, D, Gondim, I, Aroxa, F, Coriolano, M, Lins, O
• Format: Article
• Language: English
• Subjects: Cognition; Cognitive ability; Cross-sectional studies; Disease; Domains; Evaluation; Fatigue; Gender; Illnesses; Independent variables; Inventory; Mobility; Movement disorders; Neurodegenerative diseases; Parameters; Parkinson's disease; Patients; Public health; Quality of life; Regression analysis; Signs and symptoms; Sleep; Sleep and wakefulness; Sleep disorders; Sleepiness; Variables
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckaa040.036

Abstract Introduction Fatigue and sleep disorders are common in Parkinson disease (PD) patients. Fatigue is not always clinically recognized because of its subjective character manifested by feelings of extreme tiredness. These non-motor symptoms can occur from the early stages of the disease and tend to persist. Objectives To evaluate fatigue in patients with PD and the possible association with sleep disorders and other clinical parameters of the PD; and to evaluate the impact of fatigue on quality of life Methodology A cross-sectional study with 123 patients with PD was implemented. The following instruments were used: Mini Mental State Examination, the Hoehn-Yarh Scale, Beck Depression Inventory, Parkinson’s Disease Quality of Life Questionnaire, Parkinson’s Disease Sleep Scale, Epworth Sleepiness Scale, and Parkinson’s Disease Fatigue Scale. Results Fatigue was found in 48% of patients. Patients with fatigue presented longer duration of illness, depressive symptoms, cognitive impairment, severity of motor symptoms, excessive daytime sleepiness and nocturnal sleep disorder. Fatigue combined with sleep disorder occurred in 21% of the total sample, being more frequent in females (32% vs 15%) and in patients at more advanced stages of the disease (52% in HY3). The multiple logistic regression analysis indicated that the significant independent variables for the presence of fatigue were: cognition (OR = 1.19 P = 0.02), nocturnal sleep disorder (OR = 1.03 P = 0.0001); among PDSS domains, nocturnal motor symptoms (OR = 1.09 P = 0.0005) and sleep refreshment (OR = 1.11 P = 0.02); among PDQ-39 domains, mobility (OR = 0.9323 P < 0.0001) and body discomfort (OR = 0.9767 P = 0.0428). Conclusion Fatigue is common in PD, especially in the more advanced stages, and it seems to be associated with the female gender, nocturnal sleep disorder and cognition, having thus a negative impact on the quality of life.