CHANGES IN CIRCADIAN CHARACTERISTICS OF PATIENTS WITH PARKINSON DISEASE AFTER CORRECTION OF POOR SLEEP QUALITY USING MELATONIN: AN OPEN-LABEL CONTROLLED RANDOMISED TRIAL

Abstract

Introduction. Recent studies are increasing the amount of evidence suggesting that the circadian system is disrupted in Parkinson's disease that can lead to poor sleep. Currently, international guidelines for managing non-motor symptoms of Parkinson's disease do not have recommendations with proven efficacy, but only methods with potential benefit. Two of the most widely available methods for correcting poor sleep quality in patients with Parkinson's disease in Ukraine are sleep hygiene training, also known as somnoeducation, and melatonin administration. The aim of the study is to compare the state of circadian characteristics before and after the correction of poor sleep quality in patients with Parkinson's disease in the context of sleep hygiene and an integrated approach with the implementation of chronotherapy using melatonin. Materials and methods. We conducted a clinical trial at the Centre for Patients with Parkinson's Disease and Other Neurodegenerative Diseases, which included 34 patients with poor sleep quality who were randomised into 2 groups: group 1a (n = 17) consisted of patients with Parkinson's disease who followed sleep hygiene rules and received chronotherapy; group 1b (n = 17) involved patients with Parkinson's disease who followed sleep hygiene rules but did not take any medications to improve sleep. Circadian characteristics were analysed using the Munich Chronotype Questionnaire. Results. Our study has found that the correction of poor sleep quality by introducing sleep hygiene into the treatment process of patients with Parkinson's disease demonstrates a shift in the time of sleep onset and mid-sleep to earlier, accompanied by a shift in chronotypes towards earlier, as well as an increase in sleep duration against a decrease in the time spent in bed, which led to an increase in the average actual sleep efficiency. At the same time, melatonin supplementation helps to reduce sleep latency in Parkinson's disease. Conclusions. Adherence to sleep hygiene recommendations contributes to changes in circadian characteristics and improves sleep efficiency in patients with Parkinson's disease, regardless of melatonin administration. Additional use of melatonin to correct the quality of sleep for 1 month is accompanied by a reduction in the sleep latency period.