Die Parkinson’s Disease Sleep Scale (PDSS)

Zusammenfassung

Die Parkinson’s Disease Sleep Scale (PDSS) wurde entwickelt, um spezifische schlafassoziierte Symptome semiquantitativ erfassen zu können. Anhand von 15 Fragen beurteilen Patienten ihre Schlafstörungen auf einer visuellen Analogskala. Die Quantifizierung erfolgt durch Angabe der Distanz zwischen einem Wert von 0 (schwere Symptomatik) und 10 (Symptomfreiheit), wobei maximal 150 Punkte (= keine Schlafstörung) erreicht werden können. Die Evaluierung an 143 Parkinson-Patienten im Vergleich mit 137 altersentsprechenden Kontrollpersonen wies signifikante Unterschiede sowohl im PDSS-Summenscore (p < 0,0001) als auch bei 13 der 15 Items (p < 0,01) zwischen beiden Gruppen nach. Im Mittel lag der Score jedes Items bei Patienten um 1,5 Punkte niedriger im Vergleich zu den Kontrollen. Signifikante Unterschiede der Scores zwischen frühen und fortgeschrittenen Erkrankungsstadien sprechen für eine Zunahme der Schlafstörungen mit fortschreitender Erkrankung. Die Test-Retest-Reliabilität der PDSS ist hoch.

Die PDSS erlaubt es, spezifische nächtliche Symptome zu erkennen und zielgerichtet und individuell zu therapieren. Dies belegen unter anderem die Daten einer Langzeitbeobachtung an 131 Patienten, bei der sich die subjektiven schlafassoziierten Beschwerden bei Umstellung von Standard-L-Dopa auf eine retardierte Formulierung deutlich besserten.

Summary

The Parkinson’s Disease Sleep Scale (PDSS) was developed in order to quantify disease-specific nocturnal sleep problems. Patients score 15 commonly reported symptoms on a visual analogue scale. Responses are quantified by measuring the distance along a line for each item, ranging from 0 (symptom severe and always experienced) to 10 (symptom-free) with a maximum cumulative score of 150 (= no sleep disorder). Evaluation was performed with 143 patients with Parkinson’s disease and 137 age-matched healthy controls. The cumulative PDSS score (p < 0.0001) as well as the scores from 13 of 15 items (p < 0.01) were significantly different in the Parkinson group compared with the healthy controls. In each item the Parkinson group scored approximately 1.5 points lower than the controls. Significant differences in PDSS scores between early and advanced stages suggest a predisposition to sleep disruption in advancing disease. The scale showed robust test-retest reliability.

The PDSS allows sensitive differentiation of sleep disrupting factors and is thus of great value in targeting the most appropriate treatment for nocturnal symptoms in Parkinson’s disease. This conclusion is emphasized by data from an observational long-term study showing a pronounced improvement of sleep problems in 131 patients with Parkinson’s disease when switching the medication from standard L-dopa to a sustained-release formulation of L-dopa.

Schlüsselwörter

M. Parkinson - retardiertes L-Dopa - Parkinson’s Disease Sleep Scale (PDSS) - Schlafstörungen - Lebensqualität - Motorik

Keywords

Parkinson’s disease - sustained release L-dopa - Parkinson’s Disease Sleep Scale (PDSS) - nocturnal sleep disturbances - quality of life - motor symptoms

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