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Modern methods of treating sleep disorders in patients with Parkinson’s disease and previous radiation exposure

https://doi.org/10.25016/2541-7487-2020-0-3-43-51

Abstract

Relevance. Sleeplessness is a non-motor disorder that reduces the daily activity of patients with Parkinson’s disease.

Intention. To evaluate the effectiveness of the drug “Melaxen” (melatonin) in the treatment of patients with sleep disorders and daytime sleepiness in patients with Parkinson’s disease and previous radiation exposure.

Methodology. Fifty patients with Parkinson’s disease (Stage I–II according to Hen-Yar, duration of 3.5 to 6.5 years), previous radiation exposure and current sleep disorders were examined. On average, patients aged (65.8 ± 5.8) years. Most of them were employees of various departments of the Russian Emercom and Defense Ministry. On average, 38 male patients spent (56.1 ± 27.0) days in the area of radiation exposure, with exposure dose of (21.4 ± 11.9) roentgen equivalent man (rem). Female patients-inhabitants of radiation contaminated areas most likely received mean effective dose of 9 mSv (0.9 rem) per person. During treatment of Parkinson’s disease with “Levodopa” in the average daily dosage of (562.5 ± 62.5) mg (stable dose after the start of melatonin), 39 (78 %) of them also received dopamine receptor agonists at a dose of (1.0 ± 0.25) mg / day, the drug Melaxen (melatonin) was used to correct sleep disordersfor over 28 days at a daily dose of 3 mg taken 30–40 minutes before sleep daily. The clinical and psychological state of the patients was studied twice before and after completion of the course of treatment using scales to study the quality and individual significance of sleep, the hospital anxiety and depression scale (HADS), certain cognitive tests and individual sleep diaries.

Results and Discussion. According to the clinical and psychological tests, Melaxen (melatonin) contributed to improving the quality of sleep, mental well-being, activity, some cognitive functions, reducing daytime sleepiness and anxiety. The optimization of the mental state was also reflected in the personal diaries of sleep quality. A number of indicators only tended to improve, probably due to short-term studies.

Conclusion. In patients with Parkinson’s disease, “Melaxen” was associaeted with improved sleep quality, decreased daytime sleepiness and severity of anxiety and depression, and also increased concentration.

About the Authors

J. B. Slizkova
The Central policlinic N 72 of Emercom of Russia
Russian Federation

Yulia Borisovna Slizkova – Head of neurology office

Vatutin Str., 1, Moscow, 121357, Russia



V. A. Bryuzgin
The Central policlinic N 72 of Emercom of Russia
Russian Federation

Victor Aleksandrovich Bryuzgin – Chief

Vatutin Str., 1, Moscow, 121357, Russia



References

1. 30 let posle Chernobylya: patogeneticheskie mekhanizmy formirovaniya somaticheskoi patologii, opyt meditsinskogo soprovozhdeniya uchastnikov likvidatsii posledstvii avarii na Chernobyl’skoi elektrostantsii : monografiya [30 years after Chernobyl: pathogenetic mechanisms of formation of somatic pathology, experience of medical support to participants of recovery from the accident at the Chernobyl power plant: monograph]. Ed. S.S. Aleksanin. Sankt-Peterburg. 2016. 506 p. (In Russ.)

2. Gundarova O.P. Fedorov V.P., Afanas’ev R.V. Ocenka psihonevrologicheskogo statusa likvidatorov radiacionnyh avarij [Assessment of the psycho-neurological status of liquidators of radiation accidents]. Voronezh. 2012. 232 p. (In Russ.)

3. Kovrov G.V., Agaltsov M.V., Sukmarova Z.N. Effektivnost’ melatonina prolongirovannogo vysvobozhdeniya pri pervichnyh narusheniyah sna u pacientov starshe 55 let [Effectiveness of prolonged-release melatonin in improving quality of sleep in patients aged 55 or over]. Nevrologiya, nejropsihiatriya, psihosomatika [Neurology, neuropsychiatry, psychosomatics]. 2016. Vol. 8, N 2. Pp. 24–30. (In Russ.)

4. Levashkina I.M. Discirkulyatornye izmeneniya golovnogo mozga u likvidatorov posledstvij avarii na CHernobyl’skoj AES po dannym diffuzionno-tenzornoj magnitno-rezonansnoj tomografii [Dyscirculatory changes in the brain in liquidators of the consequences of the accident at the Chernobyl nuclear power plant according to the data of diffusion tensor magnetic resonance imaging]: Abstract dissertation PhD Med. Sci. Sankt-Peterburg. 2019. 24 p. (In Russ.)

5. Levin O.S. Sosudistyi parkinsonizm: 20 let spustya [Vascular parkinsonism: 20 years later]. Russkii meditsinskii zhurnal [Russian Medical Journal]. 2017. N 21. Pp. 1500–1506. (In Russ.)

6. Nodel’ M.R., Shevtsova K.V. Gipersomniya pri bolezni Parkinsona: diagnostika, patofiziologiya, podkhody k terapii [Hypersomnia in Parkinson’s disease: diagnosis, pathophysiology and management strategies]. Nevrologicheskii zhurnal [Journal of Neurology]. 2017. N 2. Pp. 57–63. (In Russ.)

7. Slizkova Yu.B., Bryuzgin V.A. Korrekciya rasstrojstv sna u sotrudnikov MCHS: rezul’taty primeneniya melatonina prolongirovannogo dejstviya [Correction of sleep disorders in EMERCOM employees: the results of using long-acting melatonin]. Nevrologiya, nejropsihiatriya, psihosomatika [Neurology, neuropsychiatry, psychosomatics]. 2017. Vol. 9, N 1. Pp. 67–70. (In Russ.)

8. Ushakov I.B., Fedorov V.P. Nejromorfologicheskie korrelyaty prolongirovannyh radiacionnyh vozdejstvij [The neuromorphological correlates of prolonged radiation exposure]. Mediko-biologicheskie i sotsial’no-psikhologicheskie problemy bezopasnosti v chrezvychaynykh situatsiyakh [Medico-Biological and Socio-Psychological Problems of Safety in Emergency Situations]. 2018. N 3. Pp. 86–97. (In Russ.)

9. Fedorov V.P. Сerebral’nye strukturno-funkcional’nye patterny frakcionirovannogo gamma–oblucheniya [Cerebral structural and functional patterns of fractionated gamma irradiation]. Stroenie organizma cheloveka i zhivotnyh v norme, patologii i eksperimente [The structure of the human body and animals in norm, pathology and experiment] : collection of scientific works. Minsk. 2017. Pp. 184–188. (In Russ.)

10. Brodsky M.A., Godbold J., Roth T. Oanow C.W. Sleeping in Parkinson’s disease: a controlled study. Mov. Disord. 2003. Vol. 18, N 6. Pp. 668–672. DOI 10.1002/mds.10429.

11. Gallagher D.A., Lees A.J., Schrag A. What are most important nonmotor symptoms in patients with Parkinson’s disease and we missing them? Mov. Disord. 2010. Vol. 25, N 15. Pp. 2493–2500. DOI 10.1002/mds.23394.

12. Sobreira-Neto M.A., Pena-Pereira M.A., Sobreira E.S.T. [et al.]. High Frequency of Sleep Disorder in Parkinson’s Disease and Its Relationship with Quality of Life. Eur. Neurol. 2017. Vol. 78, N 5-6. Pp. 330–337. DOI 10.1159/000481939.

13. Suziki К., Okuma Y., Uchiyama T. [et al.]. Impact of sleep-related symptoms on clinical motor subtypes and disability in Parkinson’s disease: a multicenter cross-sectional study. J. Neurol. Neurosurg. Psychiatry. 2017. Vol. 88, N 11. Pp. 953–959. DOI 10.1136/jnnp-2017-316136.

14. Tandberg Е., Larson J.P., Karlsen K. Excessive daytime sleeping benefi in Parkinson’s disease: a community-based study. Mov. Disord. 1999. Vol. 14, N 6. Pp. 922–927.

15. The report of the Committee without its annexes appears as Official Records of the General Assembly, Sixty-third Session, Supplement N 46. 2011. 220 р.


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For citations:


Slizkova J.B., Bryuzgin V.A. Modern methods of treating sleep disorders in patients with Parkinson’s disease and previous radiation exposure. Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations. 2020;(3):43-51. (In Russ.) https://doi.org/10.25016/2541-7487-2020-0-3-43-51

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