Freezing of gait is associated with sleep disorders in patients with Parkinson’s disease
1. In this systematic review, Parkinson’s disease patients with freezing of gait (FOG) experienced overall worse sleep quality, increased daytime sleepiness, and more disruptive sleep disturbances than those without FOG.
2. Furthermore, Parkinson’s disease patients with FOG had a higher likelihood and greater severity of rapid eye movement behavior disorder than Parkinson’s disease patients without FOG.
Evidence Rating Level: 1 (Excellent)
Patients with Parkinson’s disease (PD) experience several motor and cognitive effects. Sleep disorders are also highly prevalent in PD patients, which can have a significant impact on their quality of life. One motor symptom, freezing of gait (FOG), is suggested to be linked to sleeping disorders in these patients. Previous research has found that FOG and sleep share a bidirectional relationship, whereby those with FOG report more sleep disturbances, and those with sleep disturbances have an increased risk of developing FOG. However, no review has summarized the evidence regarding the association between FOG and sleep disorders in PD patients. Thus, the present study aimed to compare the sleep outcomes in PD patients with FOG (PD+FOG) and without FOG (PD-FOG).
Of 147 identified records, 20 studies were included in the review. Studies were included if they were conducted on PD patients aged 18 years or older and reported on any measurement of sleep and FOG in individuals. Studies were excluded if they were case reports, abstracts, editorials, case studies, or meta-analyses. The review was carried out in accordance with PRISMA guidelines. The study quality was evaluated using a customized quality checklist. The primary outcome was the prevalence of sleep disturbances and disorders in patients with PD+FOG and PD-FOG.
The results demonstrated that PD+FOG patients experienced more severe sleep disorders and disturbances than PD-FOG patients. This included overall worse sleep quality, increased daytime sleepiness, and more disruptive sleep disturbances than those without FOG. Furthermore, PD+FOG patients had higher scores on several metrics measuring rapid eye movement behavior disorder (RBD), indicating a higher likelihood and increased severity of RBD in PD+FOG patients compared to PD-FOG patients. However, the study was limited by the heterogeneity in the scales used to assess sleep disturbances in PD patients. Nonetheless, the present study demonstrated the association between FOG and sleep disturbances in PD patients.
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Image: PD
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