Objective：Excessive daytime sleepiness （EDS） is one of the most common sleep abnormalities in patients with Parkinson’s disease （PD）, yet its multifactorial etiology complicates its treatment. This review summar...Objective：Excessive daytime sleepiness （EDS） is one of the most common sleep abnormalities in patients with Parkinson’s disease （PD）, yet its multifactorial etiology complicates its treatment. This review summarized recent studies on the epidemiology, etiology, clinical implications, associated features, and evaluation of EDS in PD. The efficacy of pharmacologic and non-pharmacologic treatments for EDS in PD was also reviewed.Data Sources：English language articles indexed in PubMed and Cochrane databases and Chinese-language papers indexed in Wanfang and National Knowledge Infrastructure databases that were published between January 1987 and November 2017 were located using the following search terms： ＂sleepiness＂ , ＂sleep and Parkinson’s disease＂ , and ＂Parkinson’s disease and treatment＂ .Study Selection：Original research articles and critical reviews related to EDS in PD were selected.Results：EDS is a major health hazard and is associated with many motor and nonmotor symptoms of PD. Its causes are multifactorial. There are few specific guidelines for the treatment of EDS in PD. It is first necessary to identify and treat any possible factors causing EDS. Recent studies showed that some nonpharmacologic （i.e., cognitive behavioral therapy, light therapy, and repetitive transcranial magnetic stimulation） and pharmacologic （i.e., modafinil, methylphenidate, caffeine, istradefylline, sodium oxybate, and atomoxetine） treatments may be effective in treating EDS in PD.Conclusions：EDS is common in the PD population and can have an immensely negative impact on quality of life. Its causes are multifactorial, which complicates its treatment. Further investigations are required to determine the safety and efficacy of potential therapies and to develop novel treatment approaches for EDS in PD.展开更多
Background Excessive daytime sleepiness （EDS） is often associated with obstructive sleep apnea hypopnea syndrome （OSAHS） and contributes to a number of comorbidities in these patients. Therefore, early detection o...Background Excessive daytime sleepiness （EDS） is often associated with obstructive sleep apnea hypopnea syndrome （OSAHS） and contributes to a number of comorbidities in these patients. Therefore, early detection of EDS is critical in disease management. We examined the association between Epworth Sleepiness Scale （ESS） and multiple sleep latency test （MSLT） and diagnostic accuracy of ESS in assessing EDS in OSAHS patients. Methods The ESS, MSLT and overnight polysomnography were administered to 107 Chinese patients to assess EDS and its correlations with polysomnographic parameters. The diagnostic accuracy of ESS in classifying EDS （mean sleep latency （MSL） 〈10 minutes） was evaluated by calculating the area under ROC curve. Results As the severity of OSAHS increased, MSL decreased with increase in ESS score. Conversely, patients with worsening EDS （shorter MSL） were characterized by advanced nocturnal hypoxaemia and sleep disruption compared to those with normal MSL, suggesting EDS is associated with more severe OSAHS. There was a negative correlation between ESS score and MSL and both moderately correlated with some polysomnographic nocturnal hypoxaemic parameters. The area under ROC curve of ESS for identifying EDS was 0.80 （95% CI： 0.71 to 0.88） and ESS score 〉12 provided the best predictive value with a sensitivity of 80% and specificity of 69%. Conclusion The ESS score moderately correlates with MSL and our ROC study supports ESS as a screening strategy for assessing EDS in OSAHS.展开更多
目的探讨急性脑卒中患者日间过度嗜睡(Excessive daytime sleepiness,EDS)的相关影响因素。方法收集温州医科大学附属第一医院神经内科2018年9月-2019年2月收治的急性脑卒中发病7 d内入院的患者,进行Epworth嗜睡量表(Epworth Sleepiness...目的探讨急性脑卒中患者日间过度嗜睡(Excessive daytime sleepiness,EDS)的相关影响因素。方法收集温州医科大学附属第一医院神经内科2018年9月-2019年2月收治的急性脑卒中发病7 d内入院的患者,进行Epworth嗜睡量表(Epworth Sleepiness Scale,ESS)评分,ESS<7分为无嗜睡组;ESS≥7分为嗜睡组,同时记录性别、年龄、文化程度、家庭收入、吸烟、饮酒、高血压、糖尿病、高脂血症、卒中史、卒中类型(梗死或出血)、卒中部位、维生素D、镁等情况,评定匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、Barthel指数(the Barthel index of ADL,BI)、简易智能精神状态检查表(Minimum Mental State Examination,MMSE)等指标。分析ESS评分与上述各指标的关系。结果本研究共有295例研究对象,急性脑卒中EDS的发病率为34.9%(101人),嗜睡组与非嗜睡组对照显示性别、吸烟、PSQI评分、额叶卒中差异有统计学意义(P<0.05)。二元Logistic回归分析显示性别、额叶卒中、PSQI评分与EDS独立相关。结论急性脑卒中后EDS突出,卒中后EDS与性别、额叶卒中、睡眠质量独立相关。展开更多
文摘Objective：Excessive daytime sleepiness （EDS） is one of the most common sleep abnormalities in patients with Parkinson’s disease （PD）, yet its multifactorial etiology complicates its treatment. This review summarized recent studies on the epidemiology, etiology, clinical implications, associated features, and evaluation of EDS in PD. The efficacy of pharmacologic and non-pharmacologic treatments for EDS in PD was also reviewed.Data Sources：English language articles indexed in PubMed and Cochrane databases and Chinese-language papers indexed in Wanfang and National Knowledge Infrastructure databases that were published between January 1987 and November 2017 were located using the following search terms： ＂sleepiness＂ , ＂sleep and Parkinson’s disease＂ , and ＂Parkinson’s disease and treatment＂ .Study Selection：Original research articles and critical reviews related to EDS in PD were selected.Results：EDS is a major health hazard and is associated with many motor and nonmotor symptoms of PD. Its causes are multifactorial. There are few specific guidelines for the treatment of EDS in PD. It is first necessary to identify and treat any possible factors causing EDS. Recent studies showed that some nonpharmacologic （i.e., cognitive behavioral therapy, light therapy, and repetitive transcranial magnetic stimulation） and pharmacologic （i.e., modafinil, methylphenidate, caffeine, istradefylline, sodium oxybate, and atomoxetine） treatments may be effective in treating EDS in PD.Conclusions：EDS is common in the PD population and can have an immensely negative impact on quality of life. Its causes are multifactorial, which complicates its treatment. Further investigations are required to determine the safety and efficacy of potential therapies and to develop novel treatment approaches for EDS in PD.
基金This study was supported by grants fi-om the National Natural Science Foundation of China （NSFC） （No. 81170070, No. 81270147）, and from the Scientific Research Foundation of the Chinese Ministry of Health （No. W2012w4）.
文摘Background Excessive daytime sleepiness （EDS） is often associated with obstructive sleep apnea hypopnea syndrome （OSAHS） and contributes to a number of comorbidities in these patients. Therefore, early detection of EDS is critical in disease management. We examined the association between Epworth Sleepiness Scale （ESS） and multiple sleep latency test （MSLT） and diagnostic accuracy of ESS in assessing EDS in OSAHS patients. Methods The ESS, MSLT and overnight polysomnography were administered to 107 Chinese patients to assess EDS and its correlations with polysomnographic parameters. The diagnostic accuracy of ESS in classifying EDS （mean sleep latency （MSL） 〈10 minutes） was evaluated by calculating the area under ROC curve. Results As the severity of OSAHS increased, MSL decreased with increase in ESS score. Conversely, patients with worsening EDS （shorter MSL） were characterized by advanced nocturnal hypoxaemia and sleep disruption compared to those with normal MSL, suggesting EDS is associated with more severe OSAHS. There was a negative correlation between ESS score and MSL and both moderately correlated with some polysomnographic nocturnal hypoxaemic parameters. The area under ROC curve of ESS for identifying EDS was 0.80 （95% CI： 0.71 to 0.88） and ESS score 〉12 provided the best predictive value with a sensitivity of 80% and specificity of 69%. Conclusion The ESS score moderately correlates with MSL and our ROC study supports ESS as a screening strategy for assessing EDS in OSAHS.
文摘目的探讨急性脑卒中患者日间过度嗜睡(Excessive daytime sleepiness,EDS)的相关影响因素。方法收集温州医科大学附属第一医院神经内科2018年9月-2019年2月收治的急性脑卒中发病7 d内入院的患者,进行Epworth嗜睡量表(Epworth Sleepiness Scale,ESS)评分,ESS<7分为无嗜睡组;ESS≥7分为嗜睡组,同时记录性别、年龄、文化程度、家庭收入、吸烟、饮酒、高血压、糖尿病、高脂血症、卒中史、卒中类型(梗死或出血)、卒中部位、维生素D、镁等情况,评定匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、Barthel指数(the Barthel index of ADL,BI)、简易智能精神状态检查表(Minimum Mental State Examination,MMSE)等指标。分析ESS评分与上述各指标的关系。结果本研究共有295例研究对象,急性脑卒中EDS的发病率为34.9%(101人),嗜睡组与非嗜睡组对照显示性别、吸烟、PSQI评分、额叶卒中差异有统计学意义(P<0.05)。二元Logistic回归分析显示性别、额叶卒中、PSQI评分与EDS独立相关。结论急性脑卒中后EDS突出,卒中后EDS与性别、额叶卒中、睡眠质量独立相关。
