Difficulties with sleep are a concern for most people who have
Parkinson’s disease (PD). Researchers in Denmark used the newly developed Parkinson’s Disease Sleep Scale (PDSS)(a
visual-analog scale used to rate 15 symptoms of sleep-related symptoms in PD) to assess the level of sleep problems of 10 patients with severe PD. These measurements took place one month before and three months after the patients had operations to implant electrodes for
deep brain stimulation of the
subthalamic nucleus (DBS-STN). The researchers compared those results to responses from 10 patients with PD who were on a waiting list for the operation.
The patients who had the DBS-STN had significantly higher scores on the PDSS after than before the operation (79.8 before versus 105.3 after)—indicating that their sleep problems were much improved. Areas of improvement included overall sleep quality, difficulty falling asleep, restless legs or arms, painful muscle cramps, painful positioning of the arms or legs in the morning, and morning tremor. Nighttime bladder problems did not improve, nor did daytime sleepiness. The scores of the patients who were waiting for the operation were unchanged over the same four-month interval (87.4 at the first testing and 85.8 at the follow-up testing).
As would be expected, the patients who had DBS-STN also had fewer motor symptoms and required less medication after than before the operation, including needing 29% less dopaminergic medication. In addition, fewer patients required medications for sleep or psychiatric problems after the operation. Conversely, patients on the waiting list used more medications when they completed the second PDSS than they had needed when they completed the first PDSS.
The results of this study indicate that DBS-STN improves not only the motor symptoms of PD, but also overall sleep quality.
Hjort N, Østergaard K, Dupont E. Improvement of sleep quality in patients with advanced Parkinson’s disease treated with deep brain stimulation of the subthalamic nucleus.
Mov Disord 2004;19(2)196-199.
