Assessment of Sleep Disorder Pattern of Patients with Parkinson Disease Attending Neurology Referral Clinic in Tikur Anbessa Specialized and Zewditu Memorial Hospitals, Addis Ababa, Ethiopia
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2015-11
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Addis Ababa University
Abstract
Background: Parkinson’s disease (PD) is progressive neurodegenerative disorder characterizedby abnormal motor symptoms such as bradykinesia, tremor, rigidity, and postural instability.However, the nonmotor symptoms (NMS) of PD, including cognitive impairment, depression,psychosis,& sleep disorders are also important and could have greater significance for disability,decreased quality of life, and reduced lifespan of the patients. Sleep-related problems specific toPD may occur early and even predate the diagnosis of the disease but are generally morefrequent and more severe in patients with advanced PD. Little is known about sleep disorderpattern in people with Parkinson’s disease (PD) in Ethiopia and Africa.
Objective: To assess the prevalence of sleep disorder pattern and their associated predictors inPD patients in Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital, AddisAbaba, Ethiopia.
Methods: A cross-sectional follow up study was used to collect data on all 155 studyrespondents who visited the clinic over the four months of the study period. Data was collectedusing tool (standardized questionnaire) by trained neurology nurses and neurology residents.All the respondents were identified using a selection a criterion satisfying the required ethicalclearance procedure was used including securing verbal consent before data collection. Thencollected data was cleaned and analyzed using SPSS version 20 to determine themagnitude/prevalence of sleep disorder and regression with p-value to determine the associatedfactors that explained the dependent variable.Included: All PD patients on follow up or diagnosed during a study period fulfilling the UKBrain Bank Criteria for idiopathic PD. Exclusion criteria: included the following: PD Patientswith cognitive impairment who was unable to respond for the PDSS-2, PD Patients who didn’thave willingness to give informed consent and PD patients out of the study period.The dataincluded 155 PD patients. We used the PDSS-2 to collect sleep disorder Symptoms. Data wereentered and analyzed by a computer software SPSS version 20. First bivariate analysis was doneto identify those factors that determine the dependent variable then multivariate analysis andChi-Squares were used to determine those factors that determine the their possible associatedpredicting factors. P values<0.05 at confidence interval 95% were considered significant.
Results: Majoirity, 127 (81.9%) of the respondents were male. Almost all 140(90.6%) of therespondents getting up at night to pass urine at least one day per week and followed by 104(67%)who were unable to turn around while in bed in at least one day in a week. Patients reportedproblems on all items of sleep disorder, the least score being 4 and maximum score being 39which indicates there was no patient without sleep disturbance pattern. The most striking pointwas 13.5% of patient had a score of more than 30. Over all 30.1% of patient slept well for lessthan 3 days per week. About one third of Parkinson disease (PD) patients (35%) Wake up earlyin the morning with painful posturing of limbs. Patient’s age, marital status, employment status,Page viPD symptom duration, historical reportable sleep disturbance and disease severity were related toadvanced sleep disturbance with p- value of 0.04, 0.02, 0.00, 0.01, 0.002 and 0.001 respectively.
Conclusions: Sleep disturbance symptoms on PD patients are prevalent in our study. When disaggregated, it increase with age ,higher disease severity, disease duration, being un married and un employed and presence of reportable previous sleep disturbance before PD symptoms.Considering the prominence of sleep disturbance in PD patients in this study, there warrants
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Parkinson Disease Attending Neurology Referral Clinic