Neurological Sciences

, Volume 39, Issue 5, pp 835–839 | Cite as

Relevance of sleep quality on caregiver burden in Parkinson’s disease

  • Luigi Bartolomei
  • Andrea Pastore
  • Lucia Meligrana
  • Elena Sanson
  • Nicola Bonetto
  • Giacomo Maria Minicuci
  • Sandro Zambito Marsala
  • Tiziana Mesiano
  • Lorenzo Bragagnolo
  • Angelo Antonini
Original Article


Parkinson’s disease (PD) is a neurodegenerative disorder which affects the quality of life of patient and their family. Sleep disorders appear in 80–90% of PD patients and have a great impact on the PD well-being. We examined the relationship of patients’ sleep quality and depression on burden, mood, quality of life, and quality of sleep of their caregivers. A multicenter, regional (Veneto), observational, cross-sectional study that included 55 patient-caregiver pairs was conducted. Patients were assessed using Parkinson’s Disease Sleep Scale (PDSS) and Epworth Sleepiness Scale (ESS) for sleep disorders, Beck Depression Inventory (BDI) as a measure of depression, and Parkinson’s Disease Questionnaire (PDQ-39) as a measure of quality of life. Caregivers were evaluated by the Caregiver Burden Inventory (CBI) a measure of burden, BDI, SF-36 Health Survey as measures of HRQoL, and Medical Outcomes Study-Sleep Scale (MOS-SS) for quality of sleep. CBI, HRQoL, MOS-SS, and BDI scores displayed no association with patients’ age, cognition (Mini Mental State Examination (MMSE) and Frontal Assessment Battery (FAB)), disease duration, and Hoehn and Yahr (H&Y), and UPDRS III scales whereas were significantly correlated with patients’ quality of sleep, depression, and quality life. CBI and HRQoL were also associated respectively with patients’ ESS and l-dopa daily dose. This study underscores the presence of a significant relationship between patient and caregiver quality of life. Interestingly, sleep quality and depression rather than motor disability best predicted caregivers’ well-being


Sleep disturbance Burden caregiver Quality of life Depression Parkinson’s disease 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Dickens CM, McGowan L, Percival C, Douglas J, Tomenson B, Cotter L, Heagerty A, Creed FH (2004) Lack of a close confidant, but not depression, predicts further cardiac events after myocardial infarction. Heart 90(5):518–522. CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Gilhooly ML (1986) Senile dementia: factors associated with caregivers’ preference for institutional care. Br J Med Psychol 2(Pt 2):165–171CrossRefGoogle Scholar
  3. 3.
    Deimling GT, Poulshock SW (1985) The transition from family in-home care to institutional care. Focus on health and attitudinal issues as predisposing factors. Res Aging 7(4):563–576. CrossRefPubMedGoogle Scholar
  4. 4.
    Gilleard CJ (1987) Influence of emotional distress among supporters on the outcome of psychogeriatric day care. Br J Psychiatry 150(02):219–223. CrossRefPubMedGoogle Scholar
  5. 5.
    Martinez-Martin P, Forjaz MJ, Frades-Payo B et al (2007) Caregiver burden in Parkinson’s disease. Mov Disord 22(7):924–931. CrossRefPubMedGoogle Scholar
  6. 6.
    Edwards NE, Scheetz PS (2002) Predictors of burden for caregivers of patients with Parkinson’s disease. J Neurosci Nurs 34(4):184–190. CrossRefPubMedGoogle Scholar
  7. 7.
    Schrag A, Hovris A, Morley D, Quinn N, Jahanshahi M (2006) Caregiver-burden in Parkinson’s disease is closely associated with psychiatric symptoms, falls, and disability. Parkinsonism Relat Disord 12(1):35–41. CrossRefPubMedGoogle Scholar
  8. 8.
    Santos-Garcia D, de la Fuente-Fernandez R (2015) Factors contributing to caregivers’ stress and burden in Parkinson’s disease. Acta Neurol Scand 131(4):203–210. CrossRefPubMedGoogle Scholar
  9. 9.
    Parkinson J (1817) An essay on the shaking palsy. Sherwood, Neely, and Jones, LondonGoogle Scholar
  10. 10.
    Comella C (2007) Sleep disorders in Parkinson’s disease: an overview. Mov Disord 22(Suppl 17):S367–S373. CrossRefPubMedGoogle Scholar
  11. 11.
    Stocchi F, Barbato L, Nordera G, Berardelli A, Ruggieri S (1998) Sleep disorders in Parkinson’s disease. J Neurol 245(Suppl1):S15–S18. CrossRefPubMedGoogle Scholar
  12. 12.
    Askenasy JJM (1993) Sleep in Parkinson’s disease. Acta Neurol Scand 87(3):167–170CrossRefPubMedGoogle Scholar
  13. 13.
    Naismith SL, Hickie IB, Lewis SJ (2010) The role of mild depression in sleep disturbance and quality of life in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 22(4):384–389. CrossRefPubMedGoogle Scholar
  14. 14.
    Gjerstad MD, Wentzel-Larsen T, Aarsland D, Larsen JP (2007) Insomnia in Parkinson’s disease: frequency and progression over time. J Neurol Neurosurg Psychiatry 78:476–479CrossRefPubMedGoogle Scholar
  15. 15.
    Caap-Ahlgren M, Dehlin O (2001) Insomnia and depressive symptoms in patients with Parkinson’s disease—relationship to health-related quality of life. An interview study of patients living at home. Arch Gerontol Geriatr 32(1):23–33. CrossRefPubMedGoogle Scholar
  16. 16.
    Goldman JG, Stebbins GT, Leung V, Tilley BC, Goetz CG (2014) Relationships among cognitive impairment, sleep, and fatigue in Parkinson’s disease using the MDS-UPDRS. Parkinsonism and Related Disorders 20(11):1135–1139. CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Happe S, Berger K (2002) The association between caregiver burden and sleep disturbances in partners of patients with Parkinson’s disease. Age Ageing 31(5):349–354. CrossRefPubMedGoogle Scholar
  18. 18.
    Pal PK, Thennarasu K, Fleming J, Schulzer M, Brown T, Calne SM (2004) Nocturnal sleep disturbances and daytime dysfunction in patients with Parkinson’s disease and in their caregivers. Parkinsonism Relat Disord 10(3):157–168. CrossRefPubMedGoogle Scholar
  19. 19.
    Chaudhuri KR, Pal S, Di Marco A, Whately-Smith C, Bridgman K, Mathew R, Pezzela FR, Forbes A, Hogl B, Trenkwalder C (2002) The Parkinson’s disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson’s disease. J Neurol Neurosurg Psychiatry 73:629–635CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545. CrossRefPubMedGoogle Scholar
  21. 21.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4(6):561–571. CrossRefPubMedGoogle Scholar
  22. 22.
    Jenkinson C, Fitzpatrick R, Peto V, Greenhall R, Hyman N (1997) The Parkinson’s disease questionnaire (PDQ-39): development and validation of a Parkinson’s disease summary index score. Age Ageing 26:353–357CrossRefPubMedGoogle Scholar
  23. 23.
    Novak M, Guest C (1989) Application of a multidimensional caregiver burden inventory. Gerontolist 29:798–803Google Scholar
  24. 24.
    Ware JE Jr, , Sherbourne CD. The Mos 36-item short-form health survey (SF-36) I Concectual framework and item selection. Med Care 1992; 30: 473–483, 6CrossRefPubMedGoogle Scholar
  25. 25.
    Hays RD, Stewart AL (1992) Sleep measures. In: Stewart AL, Ware JE (eds) Measuring functioning and well-being: the Medical Outcomes Study approach. Duke University Press, Durham, pp 235–259Google Scholar
  26. 26.
    Carod-Artal FJ, Mesquita HM, Ziomkowski S, Martinez-Martin P (2013) Burden and health-related quality of life among caregivers of Brazilian Parkinson’s disease patients. Parkinsonism Relat Disord 19(11):943–948. CrossRefPubMedGoogle Scholar
  27. 27.
    Roland KP, Jenkins ME, Johnson AM (2010) An exploration of the burden experienced by spousal caregivers of individuals with Parkinson’s disease. Mov Disord 25:189–193CrossRefPubMedGoogle Scholar
  28. 28.
    Smith MC, Ellgring H, Oertel WH (1997) Sleep disturbances in Parkinson’s disease patients and spouses. J Am Geriatr Soc 45(2):194–199. CrossRefPubMedGoogle Scholar
  29. 29.
    Leroi I, Baker P, Kehoe P, Daniel E, Byrne EJ (2010) A pilot randomized controlled trial of sleep therapy in Parkinson’s disease: effect on patients and caregivers. Int J Geriatr Psychiatry 25(10):1073–1079. CrossRefPubMedGoogle Scholar
  30. 30.
    Fahn S, Elton R, Members of the UPDRS Development Committee (1987) In: Fahn S, Marsden CD, Calne DB, Goldstein M (eds) Recent developments in Parkinson’s disease, Vol 2. Florham Park. Macmillan Health Care Information:153–163, 293–304Google Scholar
  31. 31.
    Folstein SE, Folstein MF, McHugh PR (1975) “MiniMental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198. CrossRefPubMedGoogle Scholar
  32. 32.
    Dubois B, Slachevsky A, Litvan I, Pillon B (2000) The FAB: a frontal assessment battery at bedside. Neurology 55(11):1621–1626CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Luigi Bartolomei
    • 1
    • 2
  • Andrea Pastore
    • 3
  • Lucia Meligrana
    • 1
    • 4
  • Elena Sanson
    • 1
    • 4
  • Nicola Bonetto
    • 1
  • Giacomo Maria Minicuci
    • 1
  • Sandro Zambito Marsala
    • 5
  • Tiziana Mesiano
    • 6
  • Lorenzo Bragagnolo
    • 7
  • Angelo Antonini
    • 8
    • 9
  1. 1.Department of NeurosciencesSan Bortolo HospitalVicenzaItaly
  2. 2.U.O. NeurologiaOspedale San BortoloVicenzaItaly
  3. 3.Department of EconomicsCa’ Foscari UniversityVeniceItaly
  4. 4.Psychology UnitSan Bortolo HospitalVicenzaItaly
  5. 5.Neurology DepartmentSan Martino HospitalBellunoItaly
  6. 6.Neurology DepartmentCazzavillan HospitalArzignanoItaly
  7. 7.Neurology DepartmentSan Bassiano HospitalBassanoItaly
  8. 8.Parkinson and Movement Disorders UnitFondazione Ospedale San Camillo “I.R.C.C.S.”VeniceItaly
  9. 9.Department of Neurosciences (DNS)Padova UniversityPadovaItaly

Personalised recommendations