Abstract
Sleep problems are important comorbid features of, and risk factors for, neurodegenerative diseases such as Parkinson's disease (PD). To assess the prevalence and associations of sleep problems in patients with PD we analysed data from almost 54,000 participants in the Fox Insight study, including data from 38,588 patients with PD. Sleep problems are common in PD, with ~84% of respondents with PD reporting difficulty falling or staying asleep. Experiences of insomnia, restless leg syndrome, vivid dreams, acting out dreams, and the use of sleep medication are over-represented in patients with PD compared with matched healthy controls. Male sex and PD onset before the age of 50 were also associated with a greater risk of sleep problems. A physician diagnosis of insomnia was associated with more symptoms of depression, impairment of cognition-dependent independence, and a lower quality of life. Sleep problems were also associated with a higher prevalence of OFF periods compared with PD patients without sleep problems. 6.7% of PD patients endorsed sleep complaints as their most bothersome symptom, and reported non-specific poor sleep quality as the most common sleep problem. These patients also had a better quality of life and lower depression and cognitive impairments than patients for whom postural instability was their most bothersome symptom, indicating the relative burden of sleep problems is contextualised by the severity of motor symptoms. Overall, these findings reinforce the high prevalence of sleep problems in a very large sample of PD patients, and indicate important associations of sleep problems with daily function and quality of life in PD.