Sleep and impulsivity in Parkinson's disease

Parkinsonism Relat Disord. 2013 Nov;19(11):991-4. doi: 10.1016/j.parkreldis.2013.06.018. Epub 2013 Jul 21.

Abstract

Background: Impulsive behavior and poor sleep are important non-motor features of Parkinson's disease (PD) that negatively impact the quality of life of patients and their families. Previous research suggests a higher level of sleep complaints in PD patients who demonstrate impulsive behaviors, but the nature of the sleep disturbances has yet to be comprehensively tested.

Methods: Consecutive idiopathic PD patients (N = 143) completed the Minnesota Impulse Disorder Interview and a sleep questionnaire that assessed sleep efficiency, excessive daytime sleepiness, restless legs symptoms, snoring, dreams/nightmares, and nocturia. Patients were also given a Unified Parkinson's Disease Rating Scale motor examination and they completed cognitive testing.

Results: Impulsive PD patients endorsed more sleep complaints than non-impulsive PD patients. The group difference was primarily attributable to poor sleep efficiency (e.g., greater nocturnal awakenings), p < .01, and greater daytime sleepiness, p < .01, in the impulsive PD patients. Interestingly, restless legs symptoms were also greater in the impulsive PD patients, p < .05. The results could not be explained by medications or disease severity.

Conclusions: Poor sleep efficiency, restless legs symptoms, and increased daytime sleepiness are associated with impulsivity in PD. Longitudinal studies are needed to determine whether sleep disturbances precede impulsivity in PD.

Keywords: Excessive daytime sleepiness; Impulse control disorder; Parkinson's disease; Restless legs syndrome; Sleep.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Impulsive Behavior / diagnosis
  • Impulsive Behavior / physiopathology*
  • Impulsive Behavior / psychology
  • Male
  • Middle Aged
  • Parkinson Disease / diagnosis
  • Parkinson Disease / physiopathology*
  • Parkinson Disease / psychology
  • Sleep / physiology*
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / physiopathology*
  • Sleep Wake Disorders / psychology