AUTHOR=Yi Qu , Yu-Peng Chen , Jiang-Ting Li , Jing-Yi Li , Qi-Xiong Qin , Dan-Lei Wang , Jing-Wei Zhao , Zhi-Juan Mao , Yong-Jie Xiong , Zhe Min , Zheng Xue 

TITLE=Worse Sleep Quality Aggravates the Motor and Non-Motor Symptoms in Parkinson's Disease

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 14 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.887094

DOI=10.3389/fnagi.2022.887094

ISSN=1663-4365

ABSTRACT=Backgrounds: Sleep disorders are the most common and disabling symptoms for Parkinson’s disease (PD) patients. Understanding the associations of sleep characteristics with motor and non-motor symptoms (NMSs) for PD can provide evidences to guide therapeutic interventions and nursing strategies. We aimed to investigate the association of sleep characteristics with motor and NMSs of PD using multiple approaches.
Methods: A total of 328 participants were included, and all participants underwent Pittsburgh Sleep Quality Index (PSQI) evaluation and clinal assessments of PD symptoms. We conducted Spearman correlation to evaluate the associations between sleep and PD symptoms, non-linear regression to assess the relationships between sleep habits and PD, and mediated analyses to test the effects of NMSs among global PSQI and PD severity, quality of life, as well as motor symptoms.
Results: Patients with poorer sleep were linked to more severe PD symptoms. Besides, the reflection point for bedtime was around 21:52 associated with motor symptoms, and insufficient and excessive total time spent in bed and nocturnal sleep duration were correlated to higher NMS burdens. The optimal points were 8-9.2 hours and 6.2 -6.9 hours, respectively. It was also discovered that NMSs played mediating roles of global sleep with the quality of life, PD stages and motor symptoms to a varying range of 6.8-95.4%. 
Conclusions: Sleep disorders have great effects on the burden of PD symptoms. The current findings provide new insights of monitoring and management between sleep and PD, and need to further explore in future studies.