Sleep benefit in Parkinson’s disease

Many patients with Parkinson’s disease wake in the morning “off”. Patients with sleep benefit wake “on”. This sleep benefit gradually wears off over a variable period, usually about 30 to 60 minutes. Little is known about sleep benefit.1 Previous reports have produced conflicting results.2 3 No objective study has been undertaken to confirm whether sleep benefit exists or to document patients’ subjective reports that they wake in the “on state. The aims of this study were to investigate the existence of sleep benefit, to identify the characteristics of the patients who reported it, and to measure its duration. The study comprised two parts. ### INPATIENT STUDY A consecutive series of 20 patients with Parkinson’s disease admitted to the National Hospital for Neurology and Neurosurgery (NHNN) was studied by one of us (DEB). These patients were rated using the motor unified Parkinson’s disease rating scale (UPDRS)4as follows: (1) On waking, and subsequently when they turned “off” after waking before their first dose of medication. (2) “On” after medication. (3) “Off” after medication. These ratings were consecutive on the same day. The patients also completed an activities of daily living (ADL) proforma at these times. The ADL rating scale is a 25 item questionnaire in which patients are asked to rate how well they think that they can perform certain activities of daily living.5 The purpose of this part of the study was to confirm the existence of sleep benefit and assess the correlation between the objective motor UPDRS scale4 and patient’s self rated activities of daily living (ADL) scale,5 so that it could be used in the second outpatient part of the study to confirm the existence of sleep benefit in outpatients with Parkinson’s …