Medical Doctor Afya Uninovafapi Teresina, Piaui, Brazil
Introduction: Subthalamic Deep Brain Stimulation (STN-DBS) is an effective adjunctive therapy for managing motor symptoms in Parkinson’s disease (PD). However, its effect on sleep disturbances is not widely understood.
Methods: Pubmed, Embase, Scopus, and Web of Science were searched for randomized and non-randomized studies enrolling patients with PD who received DBS surgery. The outcomes of interest were the mean changes between the pre- and post-operative values of the Parkinson's Disease Sleep Scale (PDSS), REM sleep, total sleep time, sleep efficiency, Epworth Sleepiness Scale (ESS), and Wakefulness After Sleep Onset (WASO). Mean differences (MD) with 95% confidence intervals (CI) with a random effects model were used. The statistical analyses were performed using the software R Studio version 4.4.2.
Results: Twenty-three studies were included in this meta-analysis, comprising 799 patients who underwent DBS. Follow-up ranged between 3 to 52 months. There was no significant difference between pre- and post-operative time in REM sleep (MD 13.32; CI -2.19 to 28.82; p = 0.09), ESS (MD -1.35; 95% CI -2.93 to 0.22; p = 0.09), total sleep time (MD 24.99; 95% CI: -14.74 to 64.73; p = 0.22), sleep efficiency (MD 3.85; 95% CI -4.40 to 12.10; p = 0.36), WASO (MD -35.87; 95% CI -79.59 to 7.84; p = 0.11). However, PDSS (MD 17.09; 95% CI: 12.31 to 21.86; p < 0.01) was significantly higher postoperatively compared to the preoperative period in these patients.
Conclusion : This meta-analysis reveals that DBS has a limited impact on overall sleep outcomes in PD patients.
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