Sleep-related breathing disorders in Hungarian patients with Parkinson’s disease

. typical symptoms of parkinson’s disease (pd) are motor symptoms. however, the non-motor symptoms,which may occur in any phase of the disease, are now in the center of the clinical attention. these symptoms include neuropsychiatric dysfunctions, dysautonomy, sleep disorders, and sensory symptoms, such as pain. sleep disorders are commonin pd patients.Aim. the aim of our study was to estimate the prevalence and characteristics of obstructive sleep apnea syndrome (osas) inpatients with pd. We also wanted to analyze the sleep architecture in parkinson’s disease using polysomnography.Material and methods. 50 patients who had visited the neurology department of hungarian defence forces military hospital between february 2014 and april 2016 were recruited for the study. Every patient with idiopathic parkinson’s diseasestage 1 to 3 was included, regardless of their sleeping complaints. Every patient underwent nocturnal, in-laboratory polysomnography, the results of which were subsequently assessed by a somnologist. sleep stages were distinguished and the apneahypopnea index (ahi) was calculated according to the recommendations of the task force of the american academy ofsleep medicine.Results. the total in-laboratory sleep time ranged from 189 minutes to 501 minutes, with the mean value of 298 minutes. totalsleep time was reduced (< 5 hours) in 28 patients (56%). sleep latency was prolonged (< 0.5 hours) in 33 patients (> 66%). inolder patients (≥ 75 years old), the sleep latency was longer. the normal sleep efficiency of > 85% was seen in only 8 patients.the sleep efficiency ranged from 56% to 89%, with a mean value of 74.1%. 9 patients in our study group had 3 rapid eye movement (rEm) sleep episodes, 37 patients had 2 rEm episodes and 4 patients had only 1 rEm episode. there was a negativecorrelation between the score on Epworth sleepiness scale (Ess) and the number of rEm episodes. rEm sleep onset latencywas prolonged (> 2 hours) in 82% (n = 42) of our patients. periodic limb movements in sleep (plms) were seen in 18 patients.there was a negative correlation between age and plms index. all the patients in our study who had been diagnosed with restless leg syndrome (rls) had plms . sleep latency was prolonged in 7 out of 17 patients suffering from rls. 64% (n = 32) ofour patients were diagnosed with osas. the prevalence of severe, moderate and mild osas was 22%, 32% and 10%, respectively. patients with moderate and severe osas (ahi > 15 hours) had higher age than patients without osas (p < 0.005). themean Ess score was higher in osas patients (p = 0.05). snoring was present in 78% of the osas patients. apnea witnessedby a partner was the most specific symptom, present in 92% of osas patients. We did not find significant differences betweenthe groups with and without osas in regard of updrs (unified pd rating scale) and hoehn & yahr’s modified evaluationscale and schwab & England’s functional evaluation scale.Conclusions. osas is a common sleep disorder in pd patients. it has a higher prevalence in older pd patients and it is associated with greater daytime sleepiness. snoring is the most sensitive symptom, and apneas witnessed by a partner are the mostspecific symptom of osas in pd patients