Assessment of Nocturnal and Daytime Sleep disturbances among Elderly Parkinsonism Patients in Baghdad City

Abstract

Background: Sleep disturbances are one of the most common of the non-motor complications of Parkinson's disease (PD), and increase in frequency with advancing disease. As many as 98% of patients with PD may suffer at some time from nocturnal symptoms, that can disturb their sleep. The causes of sleep disturbance in PD are numerous, and many patients may have several factors that contribute. These disorders can be broadly categorized into those that involve nocturnal sleep and daytime manifestations such as excessive daytime sleepiness.

Objectives: To assess the levels of disturbances of nocturnal and daytime sleep of the Parkinson's disease patients in the city of Baghdad and to find out relationship between these levels and some demographic characteristics of patients.

Methodology: A descriptive study was conducted between the ninth of September, 2013 and 15th of December 2013. A purposive non-probability sample of 100 elderly patients who are diagnosed with Parkinson's disease and
another 75 aged matched healthy controls were recruited to participate in the study. To reach the objectives of
this study a questionnaire was constructed. The present questionnaire consists of two parts; demographic
characteristics; gender, age, and duration of illness; and 15 items as a part of Parkinson's disease Sleep Scale
(PDSS) for measuring levels of sleep disturbances.

Results: The results indicate that all the patients with Parkinson's disease have different levels of sleep
disturbances: 55.0% with severe level, 32.0% with moderate level, and only 13.0% with mild level. There is a
significant association between levels of sleep disturbances and age and duration of illness. Also the results
revealed that there were a wide difference between the Parkinson's disease group and matched healthy control
group regarding the sub-categories of sleep disturbances.

Conclusions: The results of the study indicated that more than half of PD patients had severe level of sleep
disturbance; there were significant relationships between severity of sleep disturbances and age and duration of
disease; and finally there was a difference between PD participants and matched controls group.  

Recommendations: Establishing specialized centers which give daily cares for patients with Parkinson's
disease, follow-up programs for each patient registered at these centers, and governmental financial support
for those patients.