QUALIDADE DO SONO EM PACIENTES COM DOENÇA DE PARKINSON: ANÁLISE BASEADA NA APLICAÇÃO DA ESCALA PDSS-2
DOI:
https://doi.org/10.63845/z3r93d32Palavras-chave:
Doença de Parkinson, Distúrbios do Sono, Apneia Obstrutiva do Sono, Síndrome das Pernas InquietasResumo
ABSTRACT
Objetivos: Avaliar a qualidade do sono em pacientes diagnosticados com Doença de Parkinson, atendidos pelo SUS, nos centros de especialidades médicas das cidades de Criciúma, Içara, Forquilhinha e Balneário Rincão.
Métodos: Foram avaliados 32 pacientes com doença de Parkinson, através da aplicação da escala validada Parkinson 's Disease Sleep Scale 2, relacionada aos sintomas dos distúrbios do sono. Além disso, foram coletadas informações sociodemográficas, tempo de diagnóstico, realização de terapia adjuvante e medicamentos usados para a doença de Parkinson e para o sono.
Resultados: Sobre o perfil epidemiológico dos pacientes, houve uma média de idade de 68,94 ± 8,73 anos e 56,3% eram do sexo masculino. O tempo do diagnóstico da Doença de Parkinson foi superior a 5 anos em 43,8% dos indivíduos. Todos os entrevistados usavam Prolopa e 40,6% associavam Pramipexol ao tratamento. Entre os pacientes, 59,4% relataram utilizar medicamentos para dormir, sendo que 21,9% tomavam benzodiazepínicos, 18,8% antidepressivos e 15,6% antipsicóticos. A terapia adjuvante foi referida em 53,1% dos entrevistados. Entre os distúrbios do sono, destacaram-se a noctúria (96,1%), dificuldade em se manter dormindo (81,4%), sonhos angustiantes (62,6%), roncos e dificuldades respiratórias à noite (62,5%).
Discussão: Observou-se elevada prevalência de distúrbios do sono, em concordância com a literatura, a qual reconhece o sono como uma área frequentemente afetada nessa população.
Conclusão: Identificou-se que os sintomas dos distúrbios do sono exercem determinado impacto na qualidade de vida dos pacientes, sendo importante a detecção precoce dessas alterações pelos profissionais da saúde na avaliação clínica, melhorando a qualidade de vida desses indivíduos.
Descritores: Doença de Parkinson, Distúrbios do Sono, Apneia Obstrutiva do Sono, Síndrome das Pernas Inquietas
ABSTRACT
Background: Parkinson’s disease is a chronic neurodegenerative condition with a clinic presentation of motor and non-motor symptoms. Early recognition of symptoms is essential to identify the disease.
Objective: To evaluate the quality of sleep in patients diagnosed with Parkinson's Disease, treated by the SUS, in medical specialty centers in the cities of Criciúma, Içara, Forquilhinha, and Balneário Rincão.
Methods: In total, 32 patients with Parkinson's disease were evaluated using the validated Parkinson's Disease Sleep Scale 2, related to the symptoms of sleep disorders. In addition, sociodemographic information, time of diagnosis, adjuvant therapy, and medications used for Parkinson's disease and sleep were collected.
Results: Regarding the epidemiological profile of the patients, they had a mean age of 68.94 ± 8.73 years and 56.3% were male. The time since diagnosis of Parkinson's disease was more than 5 years in 43.8% of individuals. All the patients interviewed used Prolopa and 40.6% associated Pramipexole with the treatment. Among the patients, 59.4% reported using sleeping medications, with 21.9% taking benzodiazepines, 18.8% antidepressants, and 15.6% antipsychotics. Adjuvant therapy was mentioned by 53.1% of respondents. Among the sleep disorders, nocturia (96.1%), difficulty staying asleep (81.4%), distressing dreams (62.6%), and snoring and breathing difficulties at night (62.5%) stood out.
Discussion: A high prevalence of sleep disorders was observed, in agreement with the literature, which recognizes sleep as a domain frequently affected in this population.
Conclusion: Sleep disorder–related symptoms were found to have a significant impact on patients’ quality of life, highlighting the importance of early detection of these alterations by health professionals during clinical assessment, in order to improve patients’ quality of life..
Keywords: Parkinson’s Disease, Sleep Disorders, Obstructive Sleep Apnea, Restless Legs Syndrome
Referências
Feigin VL, Vos T, Nichols E, Owolabi MO, Carroll WM, Dichgans M, et al. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):459–80. doi:10.1016/S1474-4422(18)30499-X DOI: https://doi.org/10.1016/S1474-4422(18)30499-X
Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease. Mov Disord. 2011;26(3):399–406. doi:10.1002/mds.23462 DOI: https://doi.org/10.1002/mds.23462
Bandres-Ciga S, Saez-Atienzar S, Bonet-Ponce L, Billingsley KJ, Vitale D, Blauwendraat C, et al. Large-scale pathway specific polygenic risk and transcriptomic community network analysis identifies novel functional pathways in Parkinson disease. Acta Neuropathol. 2020;140:341–58. doi:10.1007/s00401-020-02181-3 DOI: https://doi.org/10.1007/s00401-020-02181-3
Kieburtz K, Wunderle KB. Parkinson's disease: evidence for environmental risk factors. Mov Disord. 2013;28(1):8–13. doi:10.1002/mds.25150 DOI: https://doi.org/10.1002/mds.25150
Blauwendraat C, Nalls MA, Singleton AB. The genetic architecture of Parkinson’s disease. Lancet Neurol. 2020;19(2):170–8. doi:10.1016/S1474-4422(19)30287-X DOI: https://doi.org/10.1016/S1474-4422(19)30287-X
Feigin VL, Abajobir AA, Abate KH, Abd-Allah F, Abdulle AM, Abera SF, et al. Global, regional, and national burden of neurological disorders during 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurol. 2017;16(11):877–97. doi:10.1016/s1474-4422(17)30299-5 DOI: https://doi.org/10.1016/S1474-4422(17)30299-5
Dahodwala N, Shah K, He Y, Wu SS, Schmidt P, Cubillos F, et al. Sex disparities in access to caregiving in Parkinson disease. Neurology. 2018;90(1):e48–54. doi:10.1212/wnl.0000000000004764 DOI: https://doi.org/10.1212/WNL.0000000000004764
Georgiev D, Hamberg K, Hariz M, Forsgren L, Hariz GM. Gender differences in Parkinson’s disease: a clinical perspective. Acta Neurol Scand. 2017;136(6):570–84. doi:10.1111/ane.12796 DOI: https://doi.org/10.1111/ane.12796
Dugger BN, Dickson DW. Pathology of neurodegenerative diseases. Cold Spring Harb Perspect Biol. 2017;9(7):a028035. doi:10.1101/cshperspect.a028035 DOI: https://doi.org/10.1101/cshperspect.a028035
Opara J, Malecki A, Malecka E, Socha T. Motor assessment in Parkinson's disease. Ann Agric Environ Med. 2017;24(3):411–5. doi:10.5604/12321966.1232774 DOI: https://doi.org/10.5604/12321966.1232774
Goedert M. Alzheimer’s and Parkinson’s diseases: the prion concept in relation to assembled Aβ, tau, and α-synuclein. Science. 2015;349(6248):1255555. doi:10.1126/science.1255555 DOI: https://doi.org/10.1126/science.1255555
Ingelsson M. Alpha-synuclein oligomers—neurotoxic molecules in Parkinson’s disease and other Lewy body disorders. Front Neurosci. 2016;10:408. doi:10.3389/fnins.2016.00408 DOI: https://doi.org/10.3389/fnins.2016.00408
Schapira AHV, Chaudhuri KR, Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci. 2017;18(8):509. doi:10.1038/nrn.2017.91 DOI: https://doi.org/10.1038/nrn.2017.91
Zuzúárregui JRP, During EH. Sleep issues in Parkinson’s disease and their management. Neurotherapeutics. 2020;17(4):1480–94. doi:10.1007/s13311-020-00938-y DOI: https://doi.org/10.1007/s13311-020-00938-y
Mantovani S, Smith SS, Gordon R, O’Sullivan JD. An overview of sleep and circadian dysfunction in Parkinson’s disease. J Sleep Res. 2018;27(3):e12673. doi:10.1111/jsr.12673 DOI: https://doi.org/10.1111/jsr.12673
Videnovic A. Management of sleep disorders in Parkinson’s disease and multiple system atrophy: sleep in PD and MSA. Mov Disord. 2017;32(5):659–68. doi:10.1002/mds.26918 DOI: https://doi.org/10.1002/mds.26918
Trenkwalder C, Kohnen R, Högl B, Metta V, Sixel-Döring F, Frauscher B, et al. Parkinson’s disease sleep scale—validation of the revised version PDSS-2: Parkinson’s Disease Sleep Scale. Mov Disord. 2011;26(4):644–52. doi:10.1002/mds.23476 DOI: https://doi.org/10.1002/mds.23476
Gros P, Videnovic A. Sleep and circadian rhythm disorders in Parkinson’s disease. Curr Sleep Med Rep. 2017;3(3):222–34. doi:10.1007/s40675-017-0079-y DOI: https://doi.org/10.1007/s40675-017-0079-y
Barone P, Erro R, Picillo M. Quality of life and nonmotor symptoms in Parkinson’s disease. Int Rev Neurobiol. 2017;133:499–516. doi:10.1016/bs.irn.2017.05.023 DOI: https://doi.org/10.1016/bs.irn.2017.05.023
Sherer TB, Chowdhury S, Peabody K, Brooks DW. Overcoming obstacles in Parkinson’s disease: PD drug development obstacles. Mov Disord. 2012;27(13):1606–11. doi:10.1002/mds.25260 DOI: https://doi.org/10.1002/mds.25260
Holloway RG, Shoulson I, Fahn S, et al. Pramipexol vs levodopa como tratamento inicial para a doença de Parkinson: um ensaio clínico randomizado de 4 anos. Arch Neurol. 2004;61:1044. doi:10.1001/archneur.61.7.1044 DOI: https://doi.org/10.1001/archneur.61.7.1044
Amara AW, Wood KH, Joop A, et al. Ensaio randomizado e controlado de exercícios no sono objetivo e subjetivo na doença de Parkinson. Mov Disord. 2020;35:947. doi:10.1002/mds.28009 DOI: https://doi.org/10.1002/mds.28009
Johansson ME, Cameron IGM, Van Der Kolk NM, et al. O exercício aeróbico altera a função e a estrutura do cérebro na doença de Parkinson: um ensaio clínico randomizado. Ann Neurol. 2022;91:203. doi:10.1002/ana.26291 DOI: https://doi.org/10.1002/ana.26291
Gjerstad MD, et al. Insomnia in Parkinson’s disease: frequency and progression over time. J Neurol Neurosurg Psychiatry. 2007;78(5):476–9. doi:10.1136/jnnp.2006.100370 DOI: https://doi.org/10.1136/jnnp.2006.100370
Pierantozzi M, et al. Rotigotine may improve sleep architecture in Parkinson's disease: a double-blind, randomized, placebo-controlled polysomnographic study. Sleep Med. 2016;21:140–4. doi:10.1016/j.sleep.2016.01.016 DOI: https://doi.org/10.1016/j.sleep.2016.01.016
Heitkotter KH, Mazeti L, De Carvalho Aguiar PM. Avaliação da qualidade do sono em um grupo de pacientes com doença de Parkinson. Rev Bras Neurol Psiquiatr. 2015;19(1).
Tse W, et al. Clinical usefulness of the Parkinson's disease sleep scale. Parkinsonism Relat Disord. 2005;11(5):317–21. doi:10.1016/j.parkreldis.2005.02.006 DOI: https://doi.org/10.1016/j.parkreldis.2005.02.006
Palmeri R, et al. Potential predictors of quality of life in Parkinson's disease: sleep and mood disorders. J Clin Neurosci. 2019;70:113–7. doi:10.1016/j.jocn.2019.08.058 DOI: https://doi.org/10.1016/j.jocn.2019.08.058
Rana AQ, et al. Decreased sleep quality in Parkinson's patients is associated with higher anxiety and depression prevalence and severity, and correlates with pain intensity and quality. Neurol Res. 2018;40(8):696–701. doi:10.1080/01616412.2018.1462880 DOI: https://doi.org/10.1080/01616412.2018.1462880
Zhang X, et al. Prevalence of rapid eye movement sleep behavior disorder (RBD) in Parkinson's disease: a meta and meta-regression analysis. Neurol Sci. 2017;38(1):163–70. doi:10.1007/s10072-016-2744-1 DOI: https://doi.org/10.1007/s10072-016-2744-1
Postuma RB, Berg D. Advances in markers of prodromal Parkinson disease. Nat Rev Neurol. 2016;12(11):622–34. doi:10.1038/nrneurol.2016.152 DOI: https://doi.org/10.1038/nrneurol.2016.152
Ravina B, et al. The impact of depressive symptoms in early Parkinson disease. Neurology. 2007;69(4):342–7. doi:10.1212/01.wnl.0000268695.63392.10 DOI: https://doi.org/10.1212/01.wnl.0000268695.63392.10
Sun AP, Liu N, Zhang YS, et al. A relação entre apneia obstrutiva do sono e doença de Parkinson: uma revisão sistemática e meta-análise. Neurol Sci. 2020;41:1153. doi:10.1007/s10072-019-04211-9 DOI: https://doi.org/10.1007/s10072-019-04211-9
Yang X, Liu B, Shen H, et al. Prevalência da síndrome das pernas inquietas na doença de Parkinson: uma revisão sistemática e meta-análise de estudos observacionais. Sleep Med. 2018;43:40. doi:10.1016/j.sleep.2017.11.1146 DOI: https://doi.org/10.1016/j.sleep.2017.11.1146
Sobreira-Neto MA, et al. Is restless legs syndrome in Parkinson disease patients associated with any specific factor? Arq Neuropsiquiatr. 2021;79:38–43. doi:10.1590/0004-282X-anp-2020-0122 DOI: https://doi.org/10.1590/0004-282x-anp-2020-0122
Zhu K, Van Hilten JJ, Marinus J. Course and risk factors for excessive daytime sleepiness in Parkinson’s disease. Parkinsonism Relat Disord. 2016;24:34–40. doi:10.1016/j.parkreldis.2016.01.020 DOI: https://doi.org/10.1016/j.parkreldis.2016.01.020
Yoo SW, et al. Excessive daytime sleepiness and its impact on quality of life in de novo Parkinson's disease. Neurol Sci. 2019;40(6):1151–6. doi:10.1007/s10072-019-03785-8 DOI: https://doi.org/10.1007/s10072-019-03785-8
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2026 Revista Científica Arquivos Catarinenses de Medicina
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
