The use of actigraphy in clinical practice for the assessment of sleep disorders in Parkinson’s disease dementia

Background: Dementia in Parkinson’s disease dementia (PDD) and Lewy Body Dementia (LBD) are commonly associated with sleep disturbances, including rapid eye movement (REM) sleep behaviour disorder, which have a significant negative impact on quality of life. Sleep monitoring using polysomnography is poorly tolerated in patients with dementia. An alternative is the use of actigraphy. Sleep wake patterns are estimated from periods of activity and inactivity and provides statistics of sleep quality. Actigraphy has previously been used in Parkinson’s disease to quantify bradykinesia and assess sleep disorders but not specifically in those with dementia.

Methods: Five patients attending a Consultant Psychiatry Outpatient Clinic in Berkshire with PDD or LBD experiencing sleep difficulties wore actigraphy. The patients were monitored with the Respironics Actiwatch 2 device for 7 days. Sleepiness and quality of life scales and sleep diaries were recorded.

Results: The data analysis highlighted the sleep problems experienced by the patients. Behavioural and medical management was offered to patients after analysis to improve their sleep patterns and quality of life. In patient one, sleep efficiency improved by almost 10% on follow-up.

Conclusions: Actigraphy appears to be a well-tolerated, low cost, non-invasive tool for assessing and monitoring of sleep in patients with dementia. Further research to assess its utility and predictive value is needed to elucidate whether this technique can be used in everyday clinical practice.