Rasagiline improves polysomnographic sleep parameters in patients with Parkinson's disease: a double-blind, baseline-controlled trial

W Schrempf; M Fauser; M Wienecke; S Brown; A Maaß; C Ossig; K Otto; M D Brandt; M Löhle; U Schwanebeck; X Graehlert; H Reichmann; A Storch

doi:10.1111/ene.13567

Rasagiline improves polysomnographic sleep parameters in patients with Parkinson's disease: a double-blind, baseline-controlled trial

Eur J Neurol. 2018 Apr;25(4):672-679. doi: 10.1111/ene.13567. Epub 2018 Feb 27.

Authors

W Schrempf^{1

2}, M Fauser^{1

3}, M Wienecke^{1

2}, S Brown¹, A Maaß¹, C Ossig¹, K Otto¹, M D Brandt^{1

2}, M Löhle^{1

3

4}, U Schwanebeck⁵, X Graehlert⁵, H Reichmann¹, A Storch^{1

2

3

4}

Affiliations

¹ Department of Neurology, Technische Universität Dresden, Dresden, Germany.
² Interdisciplinary Sleep Laboratory, Technische Universität Dresden, Dresden, Germany.
³ Department of Neurology, University of Rostock, Rostock, Germany.
⁴ German Center for Neurodegenerative Diseases (DZNE) Rostock, Rostock, Germany.
⁵ Koordinierungszentrum für Klinische Studien (Coordination Center for Clinical Trials), Technische Universität Dresden, Dresden, Germany.

PMID: 29322594
DOI: 10.1111/ene.13567

Abstract

Background and purpose: The aim was to study the effects of rasagiline on sleep quality in patients with Parkinson's disease (PD) with sleep disturbances. Sleep disorders are common in PD. Rasagiline is widely used in patients with PD, but double-blind polysomnographic trials on its effects on sleep disturbances are missing.

Methods: This was a single-center, double-blind, baseline-controlled investigator-initiated clinical trial of rasagiline (1 mg/day) over 8 weeks in patients with PD with sleep disturbances. Blinding was achieved by running a strategic matched placebo parallel group. Co-primary outcome measures were the changes between baseline and end of the treatment period in sleep maintenance/efficiency as assessed by polysomnography and the Parkinson's Disease Sleep Scale Version 2 (PDSS-2) score.

Results: A total of 20 of 30 patients were randomized to rasagiline (mean ± SD age, 69.9 ± 6.9 years; 10 male; Hoehn-Yahr stage, 1.9 ± 0.8). Compared with baseline, sleep maintenance was significantly increased at the end of the treatment period (relative change normalized to baseline, +16.3 ± 27.9%; P = 0.024, paired two-sided t-test) and a positive trend for sleep efficiency was detected (+12.1 ± 28.6%; P = 0.097). Treatment with rasagiline led to significantly decreased wake time after sleep onset, number of arousals, percentage of light sleep and improved daytime sleepiness as measured by the Epworth Sleepiness Scale. We did not observe changes in the co-primary endpoint PDSS-2 score, and no correlations of polysomnographic sleep parameters or PDSS-2 score with motor function (Unified Parkinson's Disease Rating Scale motor score). Rasagiline was well tolerated with no unexpected adverse events.

Conclusions: In patients with PD with sleep disturbances, rasagiline showed beneficial effects on sleep quality as measured by polysomnography. These effects were probably not related to motor improvement or translated into improved overall sleep quality perception by patients.

Keywords: Parkinson's disease; night-time mobility; non-motor symptoms; polysomnography; rasagiline; sleep disorders.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Double-Blind Method
Female
Humans
Indans / therapeutic use*
Male
Middle Aged
Neuroprotective Agents / therapeutic use*
Parkinson Disease / complications*
Polysomnography / drug effects*
Sleep / drug effects*
Sleep Wake Disorders / complications*
Sleep Wake Disorders / drug therapy*
Treatment Outcome

Substances

Indans
Neuroprotective Agents
rasagiline