Obstructive sleep apnea, CPAP therapy and Parkinson's disease motor function: A longitudinal study

医学 持续气道正压 阻塞性睡眠呼吸暂停 多导睡眠图 内科学 体质指数 帕金森病 呼吸暂停-低通气指数 睡眠呼吸暂停 艾普沃思嗜睡量表 队列 前瞻性队列研究 睡眠研究 呼吸暂停 物理疗法 麻醉 心脏病学 疾病
作者
Lynn Meng,Andrea Benedetti,Anne‐Louise Lafontaine,Victoria Mery,Ann Robinson,John Kimoff,Priti Gros,Marta Kamińska
出处
期刊:Parkinsonism & Related Disorders [Elsevier BV]
卷期号:70: 45-50 被引量:33
标识
DOI:10.1016/j.parkreldis.2019.12.001
摘要

Introduction We aimed to assess, in patients with Parkinson's disease (PD), the association between obstructive sleep apnea (OSA), progression of motor dysfunction and the effect of OSA treatment. Methods Data were analysed from a prospective cohort study of idiopathic PD patients from a movement disorders clinic. Patients found to have OSA on polysomnography (apnea-hypopnea index [AHI] ≥15 events/h, OSA+) were offered treatment using continuous positive airway pressure (CPAP). CPAP+ was defined as an average ≥ 2 h/night use at each follow-up. Motor symptoms were assessed using the motor section of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (mUPDRS) and the Timed-Up-And-Go (TUG). Follow-up times were 3, 6 and 12 months. Mixed models were constructed, adjusting for age, sex, body mass index, levodopa equivalent dose and comorbidities. Results We studied 67 individuals (61.2% male) of mean age 64.7 years (SD = 10.1). Baseline mUPDRS was higher in OSA+ compared to OSA- (24.5 [13.6] vs. 16.2 [7.2], p < 0.001). Motor dysfunction increased at comparable rates in OSA- and OSA+CPAP-. However, in OSA+CPAP+, mUPDRS change was significantly lower compared to OSA- (β = −0.01 vs. 0.61, p = 0.03; p = 0.12 vs. OSA+CPAP- [β = 0.39]) and TUG change was lower compared to OSA+CPAP- (β = −0.01 vs. 0.13, p = 0.002; p = 0.05 vs. OSA- [β = 0.02]). Conclusions In this PD cohort, OSA was associated with higher baseline mUPDRS. In those with OSA, CPAP use was associated with stabilization of motor function (mUPDRS and TUG) over 12 months. These observations support further research to clarify the role of OSA in PD pathophysiology and motor dysfunction.
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