Manifestations of different sleep disorders in patients with vascular parkinsonism and their impact on prognosis.

OBJECTIVE

To investigate the clinical manifestations of various sleep disorders in patients with vascular parkinsonism (VP) and analyze their impact on disease prognosis.

METHODS

A retrospective study was conducted on 125 VP patients. Sleep disorders were assessed using the Insomnia Severity Index, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Chalder Fatigue Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Restless Legs Syndrome Severity Self-Rating Scale, REM sleep behavior disorder (RBD) Severity Questionnaire, and Idiopathic Hypersomnia Questionnaire. VP severity was evaluated using all four sections of the Unified Parkinson's Disease Rating Scale (UPDRS). Logistic regression analysis was employed to evaluate the independent impact of different sleep disorders on adverse prognosis in VP patients.

RESULTS

64.0% of patients had at least one sleep disorder, with insomnia (44.0%), RBD (37.6%), and restless legs syndrome (28.0%) being the most common. Patients with RBD had significantly higher UPDRS Part I and Part IV scores (P < 0.01). Multivariate logistic regression analysis revealed that insomnia (OR = 4.489, 95% CI: 1.903-10.589) and RBD (OR = 4.318, 95% CI: 1.814-10.280) were independent risk factors for adverse prognosis within one year.

CONCLUSIONS

VP patients have a high incidence of various sleep disorders, which are closely associated with specific motor and non-motor symptoms as well as disease prognosis. Among these, RBD and insomnia serve as important clinical indicators for predicting poor prognosis in VP patients. Early identification and intervention of these sleep disorders may help delay disease progression and improve patients' quality of life.