Somnolencia diurna excesiva y alteraciones del sueño en una cohorte con enfermedad de Parkinson evaluada durante el periodo entre mayo y noviembre del 2019, en el Hospital Teodoro Maldonado Carbo, en Guayaquil-Ecuador.

Abstract

Objective: The aim of the present study is to evaluate the presence of symptoms related to sleep disorders in an Ecuadorian cohort suffering from Parkinson's disease (PD). Methods: A cross-sectional, descriptive and comparative study was done in adult patients between 50 and 85 years old with PD from the Specialty Hospital “Teodoro Maldonado Carbo” (HTMC) -Guayaquil Ecuador- and in controls matched by age and sex. Patients with PD were evaluated to determine their clinical status according to the Hoehn and Yahr scale, Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part I, MDS-UPDRS part II and MDS-UPDRS part III. Subsequently, they were classified, using the MDS-UPDRS part II and part III, into clinical motor subtypes: Tremor dominant (TD), Postural instability with gait disturbances (PIGD) and Indeterminate. All participants performed the Parkinson's Disease Sleep Scale-2 (PDSS-2) to determine the presence of sleep disturbances (SD) and the Epworth Sleepiness Scale (ESS) to establish the presence of excessive daytime sleepiness (EDS). Results: EDS and SD were observed in more than half of the patients with PD. The probability of presenting SD (65.5% vs 17.2%, OR = 9.120, IC 95% = 2.664-31.224) and EDS (48.3% vs 17.2%, OR = 4.480, IC 95% = 1.339-14.991) is higher in people with PD, compared to controls. The PIGD subtype had a significantly higher frequency of EDS and non-motor symptoms grade, compared to the TD group. Conclusion: The present study indicates a greater probability of having symptoms related to sleep disorders in patients with PD, compared to controls. It also exposes the relationship between EDS and the clinical motor subtypes of PD.