Abstract
Background: Parkinson's disease (PD) is a common disabling and progressive neuro-degenerative disorder. Morbility and mortality are frequently associated with pulmonary dysfunction, but there is no conclusive evidence regarding the effective alteration on lung function while awake and during sleep, particularly in the first stages of disease.
Methods: 10 pts (6 M) with a mild/moderate stage of PD (Hoen & Yahr scale score ≤ 2.5); BMI 30±5, Age 66±7 (6 non-smokers, 4 ex smokers), underwent PFT + DLCO + VC in supine position, MIP, MEP, ABG, ESS and fullnight polisomnography. The next day continuous pulse-oximetry and actigraphy exam for 24 h were recorded, together with cognitive and attention tests.
Results: We did not find significant alteration in PFT, MIP, MEP, ABG and in daily pulse-oximetry; PSG data showed AHI=9±9 ev/h; RDI=25±17; time spent with SaO2 ‹90% (CT 90)= 3±5; nr. of SaO2dips ›3%/h 7±5 and a low sleep efficiency 55±12; the 24 h actigraphy recording showed a low daily physical activity = 3.4±1.2 h. A correletion was found between RDI and the psycological score, particularly with regards to attention tests (TMTB) (p‹0.05 R2=0.62) and global evaluation of frontal function (FAB) (p‹0.05 R2=0.59)
Conclusions: We observed a low prevalence of obstructive sleep apnea and hypopneas, and a high prevalence of flow limitation related to arousals (RERAs). Our data suggest a good correlation with RDI and some phycological test scores during the day. The reduction of physical activity during the day could be related to alterated rostral fluid shift and sleep disorders breathing, addressing to new alternative treatment to CPAP in patients with initial PD and SDB.
- © 2014 ERS