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Ylikoski A.,Vitalmed Research Center | Martikainen K.,Finnish Parkinson Foundation | Partinen M.,Vitalmed Research Center | Partinen M.,University of Helsinki
European Neurology | Year: 2015

Aims: Various sleep-related complications are common in Parkinson's disease (PD). The prevalence of restless legs syndrome (RLS) and its association with other symptoms were studied. Methods: Altogether, 1,447 Parkinson patients, aged 43-89, participated in a questionnaire study. Results: The response rate was 59.0% and of these, 68% returned fully answered questionnaires (n = 577). RLS occurred in 20.3% of the PD subjects. In patients with RLS, the symptoms occurred in 81.9% at least once weekly. The degree of severity was moderate in 42.7%, severe in 23.9% and very severe in 15.4%. Daytime sleepiness, fatigue, chronic insomnia, sleep maintenance insomnia, intense dreaming, and low quality of life were more common in patients with RLS than in patients without RLS. The occurrence of early onset RLS (onset ≤ age of 45 years) was 4.2%. The occurrences of late onset (>45 years) drug naïve RLS and late onset RLS (with dopaminergic medication) were 5.4 and 10.4%, respectively. Conclusion: In patients with PD, the early onset of RLS resembles idiopathic RLS with typical gender distribution and familial trait. Late onset of RLS is more common than idiopathic RLS. © 2015 S. Karger AG, Basel. Source


Ylikoski A.,Vitalmed Research Center | Martikainen K.,The Finnish Parkinson Association | Sieminski M.,Medical University of Gdansk | Partinen M.,Vitalmed Research Center | Partinen M.,University of Helsinki
Neurological Sciences | Year: 2015

There is a broad spectrum of sleep disturbances observed in Parkinson’s disease (PD). The prevalence of symptoms of insomnia and chronic inability to sleep and their association with other sleep disorders were studied. Altogether 1447 randomly selected Parkinson patients, aged 43–89 years, participated in a questionnaire study. A structured questionnaire with 207 items was based on the Basic Nordic Sleep questionnaire. Questions on demographics, PD, REM Sleep Behavior Disorder, and other issues were included. The response rate was 59 % (N = 854), and of these 81 % returned fully answered questionnaire (N = 689). Prevalence of chronic inability to sleep was 36.9 % (95 % CI 33.3–40.5). Difficulty of initiating sleep was 18.0 % (95 % CI 15.1–20.9), disrupted sleep 81.54 % (78.5–84.4), awakenings during night 31.3 % (27.8–34.8), early morning awakenings 40.4 % (36.8–44.1) and non-restorative sleep 38.5 % (34.8–42.1). In the logistic regression models, poor quality of life and restless legs syndrome correlated significantly with chronic insomnia disorder. Disrupted sleep and early morning awakenings were the most common insomnia symptoms. PD patients do not seem to have difficulties in sleep initiation. Insomnia symptoms including disruptive sleep and non-restorative sleep are common in patients with Parkinson’s disease. Inability to sleep is more common as comorbidity than a single sleep problem. © 2015, Springer-Verlag Italia. Source


Ylikoski A.,Vitalmed Research Center | Martikainen K.,Finnish Parkinson Association | Partinen M.,Vitalmed Research Center | Partinen M.,University of Helsinki
Journal of the Neurological Sciences | Year: 2014

Results The prevalence of REM sleep behavior disorder (RBD) evaluated by the RBDSQ ≥ 6 was 39.0%. The occurrences of other parasomnias (≥ 1/week) in patients with PD were: nightmares 17.2%, night terrors 3.9%, sleepwalking 1.8%, enuresis 21.0%, and hallucinations 15.3%. Occurrences (≥ 1/week) of the isolated sleep symptoms were: nocturnal sweating 28.8%, bruxism 4.7%, and sleep talking 21.7%. Association of RBD with sleepwalking (parasomnia overlap disorder) was found in 1.7% of all PD patients. Adjusted logistic regression analysis showed that weekly nightmares (OR 12.5; 95% CI 5.3 to 29.7), hallucinations (OR 5.1; 2.1 to 12.4), sleep talking (OR 11.6; 5.9 to 22.8), male gender (OR 1.9; 1.1 to 3.1), and restless legs syndrome (OR 4.7; 1.7 to 13.2) associated with the presence of RBD.Conclusion Parkinson patients with RBD have often also other parasomnias and/or isolated sleep symptoms.Background Sleep disorders are among the most common non-motor symptoms in Parkinson's disease.Method The prevalence of parasomnias and their association with other symptoms were studied in a questionnaire study among 1447 randomly selected Parkinson patients, aged 43 to 89 years. The response rate was 59.0% and of these 77% had answered to all questions that were used in the analyses (N = 661). © 2014 Elsevier B.V. All rights reserved. Source


Partinen M.,Vitalmed Research Center | Partinen M.,University of Helsinki | Kornum B.R.,Molecular Sleep Laboratory | Plazzi G.,University of Bologna | And 5 more authors.
The Lancet Neurology | Year: 2014

Narcolepsy is a sleep disorder characterised by loss of hypothalamic hypocretin (orexin) neurons. The prevalence of narcolepsy is about 30 per 100 000 people, and typical age at onset is 12-16 years. Narcolepsy is strongly associated with the HLA-DQB1*06:02 genotype, and has been thought of as an immune-mediated disease. Other risk genes, such as T-cell-receptor α chain and purinergic receptor subtype 2Y11, are also implicated. Interest in narcolepsy has increased since the epidemiological observations that H1N1 infection and vaccination are potential triggering factors, and an increase in the incidence of narcolepsy after the pandemic AS03 adjuvanted H1N1 vaccination in 2010 from Sweden and Finland supports the immune-mediated pathogenesis. Epidemiological observations from studies in China also suggest a role for H1N1 virus infections as a trigger for narcolepsy. Although the pathological mechanisms are unknown, an H1N1 virus-derived antigen might be the trigger. © 2014 Elsevier Ltd. Source


Sieminski M.,Medical University of Gdansk | Losy J.,Polish Academy of Sciences | Partinen M.,Vitalmed Research Center | Partinen M.,University of Helsinki
Sleep Medicine Reviews | Year: 2015

Restless legs syndrome (RLS) is a sleep-related sensory-motor disorder characterized by an irresistible urge to move the legs accompanied by unpleasant sensations in the lower extremities. According to many recent studies patients with multiple sclerosis (MS) suffer frequently from symptoms of RLS. The prevalence of RLS in MS patients varies 13.3%-65.1%, which is higher than the prevalence of RLS in people of the same age in the general population. MS patients with RLS have higher scores in the Expanded Disability Status Scale compared to MS patients without RLS. Presence of RLS has a negative impact on sleep quality and fatigue of MS patients. Iron deficiency and chronic inflammation may be factors contributing to development of RLS in MS. The relationship between the course and treatment of MS and RLS requires further prospective studies. © 2014 Elsevier Ltd. Source

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