Clinical and psychometric analysis of sleep disturbances and affective disorders in Parkinson’s disease

Sleep disturbances and affective disorders are among the most common and clinically significant non-motor manifestations of Parkinson’s disease. Despite their high prevalence, the relative contribution of anxiety and depression to the development of sleep disturbances in this patient population remains insufficiently studied. The aim of the study was to investigate the relationship between affective disorders and sleep disturbances in patients with Parkinson’s disease, as well as to assess the associations of these parameters with the main clinical and demographic characteristics of the disease. A retrospective analytical study was performed using a database of 134 patients with Parkinson’s disease. The analysis included sex, age, age at disease onset, disease duration, Hoehn and Yahr stage, cognitive status assessed by the MoCA scale, disease severity assessed by the UPDRS, as well as the severity of anxiety and depression according to the HADS. Sleep quality was assessed using the Spiegel Sleep Questionnaire. Worsening sleep was associated with greater severity of both anxiety and depressive symptoms: the median HADS-A score increased from 6.0 [5.0; 7.0] to 8.0 [5.5; 10.0] points (p = 0.026), whereas the median HADS-D score increased from 6.5 [4.0; 8.8] to 9.0 [6.0; 11.0] points (p = 0.045). Categorical analysis revealed a statistically significant association between anxiety and the frequency of sleep disturbances (χ² = 10.541; p = 0.032). In logistic regression analysis, a 1-point increase in HADS-A was associated with a higher probability of clinically significant sleep disturbance (OR 1.155; 95 % CI 1.014–1.316; p = 0.030), while a 1-point increase in HADS-D increased this probability by 20.2 % (OR 1.202; 95 % CI 1.047–1.380; p = 0.009). When anxiety and depression were entered into the model simultaneously, only depression retained an independent association with sleep disturbance (OR 1.160; 95 % CI 1.003–1.341; p = 0.045). Additionally, depressive symptoms were associated with lower MoCA scores (ρ = -0.203; p = 0.018), whereas both anxiety and depression correlated with longer disease duration and greater disease severity. Sleep disturbances in patients with Parkinson’s disease are highly prevalent and closely associated with affective symptomatology. Notably, unlike anxiety, depression retained an independent association with clinically significant sleep disturbance after adjustment for major clinical factors. These findings highlight the need for routine screening for affective disorders, especially depression, in patients with Parkinson’s disease who complain of poor sleep.

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