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J Clin Neurol.  2020 Jan;16(1):66-74. 10.3988/jcn.2020.16.1.66.

Subtypes of Sleep Disturbance in Parkinson's Disease Based on the Cross-Culturally Validated Korean Version of Parkinson's Disease Sleep Scale-2

Affiliations
  • 1Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • 2Deparment of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
  • 4Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 5Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea.
  • 6Department of Neurology, Dong-A University College of Medicine, Busan, Korea.
  • 7Department of Neurology and Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 8Department of Neurology, Hallym University College of Medicine, Anyang, Korea.
  • 9Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea.
  • 10Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 11Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 12Department of Neurology, Parkinson/Alzheimer Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 13Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 14Department of Neurology, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 15Department of Neurology, Gachon University Gil Hospital, College of Medicine, Gachon University, Incheon, Korea.
  • 16Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
  • 17Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 18Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, College of Medicine, Seoul National University, Seoul, Korea.
  • 19Department of Neurology, Chungbuk National University School of Medicine, Chungbuk National University Hospital, Cheongju, Korea.
  • 20Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
  • 21Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
  • 22Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 23Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea.
  • 24Department of Neurology, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, Korea.
  • 25Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 26Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.
  • 27Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Korea.
  • 28Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • 29Department of Neurology, Hanyang University College of Medicine, Seoul, Korea.
  • 30Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. jsk502@hotmail.com
  • 31Dementia and Neurodegenerative Disease Research Center, Inje University, Busan, Korea.

Abstract

BACKGROUND AND PURPOSE
This study aimed to determine the clinimetric properties of the Korean version of Parkinson's Disease Sleep Scale-2 (K-PDSS-2) and whether distinct subtypes of sleep disturbance can be empirically identified in patients with Parkinson's disease (PD) using the cross-culturally validated K-PDSS-2.
METHODS
The internal consistency, test-retest reliability, scale precision, and convergent validity of K-PDSS-2 were assessed in a nationwide, multicenter study of 122 patients with PD. Latent class analysis (LCA) was used to derive subgroups of patients who experienced similar patterns of sleep-related problems and nocturnal disabilities.
RESULTS
The total K-PDSS-2 score was 11.67±9.87 (mean±standard deviation) at baseline and 12.61±11.17 at the retest. Cronbach's α coefficients of the total K-PDSS-2 scores at baseline and follow-up were 0.851 and 0.880, respectively. The intraclass correlation coefficients over the 2-week study period ranged from 0.672 to 0.848. The total K-PDSS-2 score was strongly correlated with health-related quality of life measures and other corresponding nonmotor scales. LCA revealed three distinct subtypes of sleep disturbance in the study patients: "less-troubled sleepers,""PD-related nocturnal difficulties," and "disturbed sleepers."
CONCLUSIONS
K-PDSS-2 showed good clinimetric attributes in accordance with previous studies that employed the original version of the PDSS-2, therefore confirming the cross-cultural usefulness of the scale. This study has further documented the first application of an LCA approach for identifying subtypes of sleep disturbance in patients with PD.

Keyword

Parkinson disease; sleep; Parkinson's Disease Sleep Scale-2; Korean version; validity; latent class analysis

MeSH Terms

Follow-Up Studies
Humans
Parkinson Disease*
Quality of Life
Weights and Measures

Figure

  • Fig. 1 Predicted symptom profiles of K-PDSS-2 item responses for the sleep-disturbance subtypes based on latent class analysis. K-PDSS-2: Korean version of Parkinson's Disease Sleep Scale-2, PD: Parkinson's disease.


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