Obstructive sleep apnea, CPAP therapy and Parkinson's disease motor function: A longitudinal study.

We aimed to assess, in patients with Parkinson's disease (PD), the association between obstructive sleep apnea (OSA), progression of motor dysfunction and the effect of OSA treatment. Data were analysed from a prospective cohort study of idiopathic PD patients from a movement disorders clinic. Patients found to have OSA on polysomnography (apnea-hypopnea index [AHI] ≥15 events/h, OSA+) were offered treatment using continuous positive airway pressure (CPAP). CPAP+ was defined as an average ≥ 2 h/night use at each follow-up. Motor symptoms were assessed using the motor section of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (mUPDRS) and the Timed-Up-And-Go (TUG). Follow-up times were 3, 6 and 12 months. Mixed models were constructed, adjusting for age, sex, body mass index, levodopa equivalent dose and comorbidities. We studied 67 individuals (61.2% male) of mean age 64.7 years (SD = 10.1). Baseline mUPDRS was higher in OSA+ compared to OSA- (24.5 [13.6] vs. 16.2 [7.2], p < 0.001). Motor dysfunction increased at comparable rates in OSA- and OSA+CPAP-. However, in OSA+CPAP+, mUPDRS change was significantly lower compared to OSA- (β = -0.01 vs. 0.61, p = 0.03; p = 0.12 vs. OSA+CPAP- [β = 0.39]) and TUG change was lower compared to OSA+CPAP- (β = -0.01 vs. 0.13, p = 0.002; p = 0.05 vs. OSA- [β = 0.02]). In this PD cohort, OSA was associated with higher baseline mUPDRS. In those with OSA, CPAP use was associated with stabilization of motor function (mUPDRS and TUG) over 12 months. These observations support further research to clarify the role of OSA in PD pathophysiology and motor dysfunction.

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest Dr. Marta Kaminska holds research operating grants from the Canadian Institutes of Health Research and Weston Brain Institute, and is supported by the Fonds de Recherche du Quebec – Santé. She has received research support from Philips-Respironics., ResMed Corp., VitalAire Inc, and Fisher Paykel. She has received consultant fees from and serves as advisory board member for Biron Soins du Sommeil. Dr. Anne-Louise Lafontaine serves as advisory board member for Abbvie and Merz. Dr. Andrea Benedetti holds operating grants from the Canadian Institutes of Health Research, and is supported by the Fonds de Recherche du Quebec – Santé. Dr. R. John Kimoff holds research operating grants from the Canadian Institutes of Health Research, Fonds de Recherche du Quebec – Santé, and The Multiple Sclerosis Society of Canada. He has received research operating support from Philips-Respironics Inc., ResMed Inc., and VitalAire Inc. The other authors have nothing to declare.