Objective To investigate the efficacy of levodopa/carbidopa/entacapone (LCE) at bedtime for treating sleep disturbance in patients with Parkinson’s disease (PD) with motor fluctuations.
Methods Participants included 128 PD patients with motor fluctuations. All patients were assessed for motor, nonmotor, and sleep-specific symptoms using the United Parkinson’s Disease Rating Scale (UPDRS), the Korean version of the Nonmotor Symptom Scale, the Parkinson’s Disease Sleep Scale (PDSS), the Epworth Sleepiness Scale, and the Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDSQ). We compared the baseline characteristics of patients with sleep disturbance (PDSS score < 120) and those without sleep disturbance (PDSS score ≥ 120). Thirty-nine patients with sleep disturbance who agreed to take LCE at bedtime completed 3-month follow-ups. We analyzed changes in the scores of motor, nonmotor, and sleep symptom scales over the 3 months.
Results PD patients with sleep disturbance were at more advanced disease stages and had more severe motor, nonmotor, and sleep symptoms than those without sleep disturbance. Patients who took LCE at night showed improvements in motor (UPDRS part III, p = 0.007) and sleep symptoms (total PDSS, p < 0.001). Sleep features that benefitted from LCE included not only nocturnal motor components but also insomnia (PDSS items 2 and 3, p = 0.005 and p < 0.001) and rapid eye movement behavior disorder (PDSS item 6, p = 0.002; and RBDSQ, p < 0.001).
Conclusion The use of LCE at bedtime may be a useful treatment for sleep disturbance in advanced PD patients with motor fluctuations.
Citations
Citations to this article as recorded by
Comparison of sleep characteristics between Parkinson's disease with and without freezing of gait: A systematic review Tracy Milane, Clint Hansen, Mathias Baptiste Correno, Matthias Chardon, Fabio A. Barbieri, Edoardo Bianchini, Nicolas Vuillerme Sleep Medicine.2024; 114: 24. CrossRef
Sleep and sleep disorders in people with Parkinson's disease Alex Iranzo, Valerie Cochen De Cock, María Livia Fantini, Laura Pérez-Carbonell, Lynn Marie Trotti The Lancet Neurology.2024; 23(9): 925. CrossRef
Opicapone versus entacapone: Head‐to‐head retrospective data‐based comparison of healthcare resource utilization in people with Parkinson's disease new to catechol‐O‐methyltransferase (COMT) inhibitor treatment Glynn Harrison‐Jones, Xiaocong Li Marston, Francesca Morgante, K. Ray Chaudhuri, Guillermo Castilla‐Fernández, Valentina Di Foggia European Journal of Neurology.2023; 30(10): 3132. CrossRef
Management of REM sleep behavior disorder: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment Michael Howell, Alon Y. Avidan, Nancy Foldvary-Schaefer, Roneil G. Malkani, Emmanuel H. During, Joshua P. Roland, Stuart J. McCarter, Rochelle S. Zak, Gerard Carandang, Uzma Kazmi, Kannan Ramar Journal of Clinical Sleep Medicine.2023; 19(4): 769. CrossRef
The real-life effect of catechol-O-methyltransferase inhibition on non-motor symptoms in levodopa-treated Parkinson’s disease: opicapone versus entacapone Valentina Leta, Daniel J. van Wamelen, Federico Aureli, Vinod Metta, Dhaval Trivedi, Pietro Cortelli, Carmen Rodriguez-Blazquez, Alexandra Rizos, K. Ray Chaudhuri Journal of Neural Transmission.2023; 130(7): 925. CrossRef
Non-oral continuous drug delivery based therapies and sleep dysfunction in Parkinson’s disease P. Tall, M. A. Qamar, L. Batzu, V. Leta, C. Falup-Pecurariu, K. Ray Chaudhuri Journal of Neural Transmission.2023; 130(11): 1443. CrossRef
Tenuigenin promotes non-rapid eye movement sleep via the GABAA receptor and exerts somnogenic effect in a MPTP mouse model of Parkinson's disease Di Zhang, Wenjing Zhang, Shumin Deng, Lu Liu, Hua Wei, Fenqin Xue, Hui Yang, Xiaomin Wang, Zheng Fan Biomedicine & Pharmacotherapy.2023; 165: 115259. CrossRef
Real‐world considerations regarding the use of the combination of levodopa, carbidopa, and entacapone (Stalevo®) in Parkinson's disease Heinz Reichmann European Journal of Neurology.2023; 30(S2): 15. CrossRef
Clinical profile of levodopa-carbidopa-entacapone intestinal gel infusion in patients with advanced Parkinson’s disease Karina A. Atanasova-Ivanova, Sonya Ivanova Hristova-Chakmakova, Ivan G. Milanov Folia Medica.2023; 65(6): 929. CrossRef
The Home-Based Sleep Laboratory Yael Hanein, Anat Mirelman, Anat Mirelman, E. Ray Dorsey, Patrik Brundin, Bastiaan R. Bloem Journal of Parkinson's Disease.2021; 11(s1): S71. CrossRef
Shudi Pingchan Decoction combined with repetitive transcranial magnetic stimulation in the treatment of Parkinson’s disease with sleep disorders Qing Ye, Xiqun Chen, Yuqing Hu, Jie Zhou, Chen Gao, Zhenguo Liu Traditional Medicine and Modern Medicine.2020; 03(02): 85. CrossRef