ABSTRACT
BACKGROUND: The prevalence of sleep disturbances among patients with Parkinson's disease (PD) is estimated to occur in 37% to 98% of patients. Sleep disturbances have been associated with a reduced quality of life for patients with PD. The objective of this study was to assess the impact of rasagiline treatment on the severity of sleep disturbances among patients with idiopathic PD. METHODS: In this open-label, multicentre study, 110 adult patients with idiopathic PD were treated with rasagiline either as monotherapy or as adjunct therapy. The primary endpoint was the change in severity of sleep disturbances, assessed with the PD Sleep Scale from baseline to month 2. Exploratory endpoints included change in daytime sleepiness, assessed with the Epworth Sleep Scale, treatment satisfaction measured with the Treatment Satisfaction Questionnaire for Medication, patient's overall improvement or deterioration over time measured with the Clinical Global Impression of Improvement, tolerability, and safety. FINDINGS: Patients treated with rasagiline as mono- or adjunct therapy showed a statistically significant improvement in sleep quality after 2 months. There was no change in daytime sleepiness. Overall, patients were satisfied with rasagiline treatment with a mean Treatment Satisfaction Questionnaire for Medication [standard deviation] total score at month 2 of 68% [16.1]. At the end of study, 64 patients (65.9%) were judged, by the investigator, as being at least minimally improved from baseline on the Clinical Global Impression of Improvement. Rasagiline was safe and well-tolerated. INTERPRETATION: Rasagiline as mono- or adjunct-therapy may improve sleep experience in patients with PD in the short term.
Subject(s)
Indans/therapeutic use , Neuroprotective Agents/therapeutic use , Parkinson Disease/complications , Sleep Wake Disorders/drug therapy , Sleep Wake Disorders/etiology , Aged , Dose-Response Relationship, Drug , Female , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Retrospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
The effects of sauna alone vs exercise and sauna on ambulatory blood pressure monitoring and central hemodynamic variables were measured in 16 patients with untreated hypertension assigned to a control period, sauna, or exercise and sauna. Exercise and sauna had positive effects on 24-hour systolic and mean blood pressure in patients with untreated hypertension. Exercise and sauna and sauna alone reduce total vascular resistance, with positive effects lasting up to 120 minutes after heat exposure.
Subject(s)
Blood Pressure/physiology , Exercise/physiology , Hemodynamics/physiology , Hypertension/physiopathology , Steam Bath , Adult , Aged , Blood Pressure Monitoring, Ambulatory , Cardiac Output/physiology , Cross-Over Studies , Female , Heart Rate/physiology , Humans , Male , Middle Aged , Stroke Volume/physiology , Time Factors , Treatment Outcome , Vascular Resistance/physiologyABSTRACT
PURPOSE: We measured the effects of sauna bathing alone or a 30-minute exercise session followed by sauna bathing on short-term heart rate variability (HRV) in subjects with untreated hypertension. METHODS: Ten patients with untreated hypertension (age 59 ± 10 years) were randomly assigned to (1) a control resting session, (2) two 8-minute sauna-only sessions (S), or (3) a 30-minute aerobic exercise session at 75% of maximal heart rate followed by a sauna session (ES). Spectral analysis of HRV was measured with a Polar S810 heart rate monitor at baseline, during the sauna session, and 15 and 120 minutes after the sauna session (T15 and T120). A Fast Fourier Transformation was used to quantify the power spectral density of the low-frequency (LF) and high-frequency (HF) bands. RESULTS: For S and ES conditions, LF (NU, normalized unit) and LF/HF were significantly higher (P < .05 and P < .01) in the first and second sauna sessions, and HF (NU) was significantly lower (P < .05, first sauna). At baseline and T15 for S and ES versus control, LF (NU) and LF/HF were significantly higher (P < .05), and HF (NU) was significantly lower (P < .05), without any effect of the 30-minute exercise session. CONCLUSIONS: A single sauna session induced a significant alteration of autonomic cardiovascular control in patients with untreated hypertension, with an increased sympathetic and decreased parasympathetic drive. These alterations were normalized within 15 to 120 minutes after sauna bathing. Additional studies are required to document long-term effects of chronic sauna bathing on autonomic control in patients with hypertension.
