Sleep and Biological Rhythms

, Volume 17, Issue 1, pp 103–112 | Cite as

Evaluation of sleep quality in individuals with Parkinson’s disease using objective and subjective measures

  • Isabela Andrelino de Almeida
  • Arthur Eumann Mesas
  • Marcelle Brandão Terra
  • Rogério José de Sousa
  • Henrique Ballalai Ferraz
  • Suhaila Mahmoud SmailiEmail author
Original Article


The aim of this study is to investigate sleep quality in Parkinson’s disease (PD) and to correlate subjective measures, through clinical scales and sleep diary, with objective measures obtained by means of actigraphy. In this prospective comparative study, the population consisted of PD patients with a moderate stage of the disease, who were evaluated by subjective scales such as the Pittsburgh Sleep Quality Index—PSQI, Epworth Sleepiness Scale—ESS, Parkinson’s Disease Sleep Scale—PDSS and by sleep diary, besides objective measures from actigraphy recording over seven consecutive days. Participants were categorized into two groups: “good sleep” = PDSS > 100 and “poor sleep” = PDSS ≤ 100. In total, 48 individuals were evaluated, and the overall median (inter-quartile range) was 68 (55–70) for years of age, 95.3 (73.1–111.8) for PDSS, 8 (5–11) for PSQI. Twenty-eight (58.3%) participants had poor sleep quality according to the PDSS. Poor sleep quality was associated with higher depression score (p = 0.01) and with living without partner (p = 0.04). A significant difference was observed in all items of PDSS, except in the item daytime dozing (p = 0,10). Actigraphy—and sleep diary-based parameters did not vary according to the sleep quality measured with the PDSS. In general, subjective and objective sleep parameters presented weak to moderate correlation, except for sleep latency and sleep efficiency. Sleep quality is impaired in PD when assessed by actigraphy, clinical sleep scales and sleep diary. Parameters measured objectively should not be replaced by subjective parameters and vice versa due to the complexity of individual’s perception about sleep.


Parkinson’s disease Sleep Actigraphy Rehabilitation 



This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

Compliance with ethical standards

Conflict of interest

There are no potential conflicts of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical Committee Permission: Local Ethics Committee in Research with Human Beings, under the opinion of the CEP-UEL approval no. 1.356.676.


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Copyright information

© Japanese Society of Sleep Research 2018

Authors and Affiliations

  • Isabela Andrelino de Almeida
    • 1
  • Arthur Eumann Mesas
    • 2
  • Marcelle Brandão Terra
    • 1
  • Rogério José de Sousa
    • 1
  • Henrique Ballalai Ferraz
    • 3
  • Suhaila Mahmoud Smaili
    • 1
    Email author
  1. 1.Department of Physical TherapyUniversidade Estadual de LondrinaLondrinaBrazil
  2. 2.Department of Public HealthUniversidade Estadual de LondrinaLondrinaBrazil
  3. 3.Department of Neurology and NeurosurgeryUniversidade Federal de São PauloSão PauloBrazil

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