Negative influence of L-dopa on subjectively assessed sleep but not

Negative influence of L-dopa on subjectively assessed sleep but not

Pharmacological Reports
Copyright © 2013
2013, 65, 614–623
by Institute of Pharmacology
ISSN 1734-1140
Polish Academy of Sciences
Negative influence of L-dopa on subjectively
assessed sleep but not on nocturnal
polysomnography in Parkinson’s disease
Jakub M. Antczak1, Maria J. Rakowicz1, Marta Banach1,
Miros³awa Derejko1, Jakub Sienkiewicz2, Urszula Zalewska1,
Ma³gorzata Wiêc³awska1, Tomasz Jakubczyk1, Wojciech Jernajczyk1
1
Department of Clinical Neurophysiology, Institute of Psychiatry and Neurology, Sobieskiego 9,
PL 02-957, Warszawa, Poland
2
Department of Neurology, Faculty of Health Science, Medical University of Warsaw, Kondratowicza 8,
PL 03-242, Warszawa, Poland
Correspondence: Jakub Antczak, e-mail: [email protected]
Abstract:
Background: Sleep disorders are highly prevalent among patients with Parkinson’s disease (PD). Chronic medication with L-dopa
may be one of the factors that contributes to poor sleep quality. The aim of this study was to assess the effects of long term use of
L-dopa on objective and subjective measures of sleep quality in PD patients.
Methods: Twenty-seven PD patients (mean age 62.5 ± 8.6 years, mean disease duration 7.3 ± 5.9 years, 11 females) underwent nocturnal polysomnography. Their sleep was rated subjectively using the Parkinson’s disease sleep scale (PDSS), and their disease severity was assessed using the unified Parkinson’s disease severity scale (UPDRS) standard questionnaire. Doses of L-dopa and other
medications were correlated with parameters of sleep quality. The polysomnographic recordings were compared with those from
24 age- and gender-matched normal controls.
Results: The patients showed decreased total sleep time (TST) and sleep efficiency (SE), prolonged sleep onset and REM sleep
latency and wake after sleep onset (WASO). Parts I–III of the UPDRS scores correlated with TST, SE and WASO but not with PDSS
scores. L-dopa dosage and part IV of the UPDRS correlated with PDSS scores but not with polysomnographic parameters.
Conclusions: Higher doses of chronically administered L-dopa correlated with lower sleep quality according to the subjective measures but not according to the polysomnographic parameters, which were related to the severity of PD symptoms. The low sleep quality according to the subjective measurements may result from complications of therapy at high doses of L-dopa.
Key words:
Parkinson’s disease, L-dopa, dopamine agonists, sleep quality, polysomnography
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Pharmacological Reports, 2013, 65, 614–623