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Peer-reviewedCC BYClinical parkinsonism & related disorders

Changes in sleep disturbances and quality of life associated with Istradefylline in patients with Parkinson's disease: an exploratory polysomnographic study.

  1. 1Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
  2. 2Department of Neurology, Saiseikai Matsuyama Hospital, Matsuyama, Ehime, Japan.

Abstract

Background

Sleep disturbances are common non-motor symptoms in Parkinson's disease (PD) and substantially impair quality of life (QOL). Although istradefylline, an adenosine A2A receptor antagonist, is widely used to improve motor fluctuations, its effects on subjective sleep complaints and objective sleep architecture remain unclear.Methods

In this exploratory, single-center, open-label study, we evaluated changes in subjective sleep quality and polysomnographic findings following 12 weeks of istradefylline treatment in patients with PD. Nine patients underwent clinical assessments and overnight polysomnography at baseline and 12 weeks after initiating istradefylline (20 mg/day). Sleep quality, QOL, fatigue, and motor symptoms were assessed using validated clinical scales.Results

Following istradefylline initiation, improvements were observed in Parkinson's Disease Sleep Scale-2 (PDSS-2), Parkinson's Disease Questionnaire-39 summary index (PDQ-39 SI), Parkinson Fatigue Scale, and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part IV scores. Changes in PDSS-2 scores were significantly correlated with changes in PDQ-39 SI (ρ = 0.76, p = 0.017), although both measures were subjective and obtained at the same assessment. Regarding objective sleep measures, most polysomnographic parameters did not significantly change; rapid eye movement (REM) sleep percentage increased numerically, but the change was not statistically significant (p = 0.058).Conclusions

In this small uncontrolled study, initiation of istradefylline was associated with improvements in subjective sleep quality, fatigue, and QOL, whereas objective polysomnographic parameters showed limited changes. These findings are exploratory and hypothesis-generating and require confirmation in larger controlled studies.

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BibTeX
@article{miyaue2026changes,
  title = {{Changes in sleep disturbances and quality of life associated with Istradefylline in patients with Parkinson's disease: an exploratory polysomnographic study.}},
  author = {Noriyuki Miyaue and Hayato Yabe},
  journal = {Clinical parkinsonism \& related disorders},
  year = {2026},
  month = oct,
  doi = {10.1016/j.prdoa.2026.100512},
  url = {https://europepmc.org/article/MED/42921407},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Changes in sleep disturbances and quality of life associated with Istradefylline in patients with Parkinson's disease: an exploratory polysomnographic study.
AU  - Noriyuki Miyaue
AU  - Hayato Yabe
PY  - 2026
DA  - 2026/10/13
JO  - Clinical parkinsonism & related disorders
DO  - 10.1016/j.prdoa.2026.100512
UR  - https://europepmc.org/article/MED/42921407
AB  - Background  Sleep disturbances are common non-motor symptoms in Parkinson's disease (PD) and substantially impair quality of life (QOL). Although istradefylline, an adenosine A2A receptor antagonist, is widely used to improve motor fluctuations, its effects on subjective sleep complaints and objective sleep architecture remain unclear.Methods  In this exploratory, single-center, open-label study, we evaluated changes in subjective sleep quality and polysomnographic findings following 12 weeks of istradefylline treatment in patients with PD. Nine patients underwent clinical assessments and overnight polysomnography at baseline and 12 weeks after initiating istradefylline (20 mg/day). Sleep quality, QOL, fatigue, and motor symptoms were assessed using validated clinical scales.Results  Following istradefylline initiation, improvements were observed in Parkinson's Disease Sleep Scale-2 (PDSS-2), Parkinson's Disease Questionnaire-39 summary index (PDQ-39 SI), Parkinson Fatigue Scale, and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part IV scores. Changes in PDSS-2 scores were significantly correlated with changes in PDQ-39 SI (ρ = 0.76, p = 0.017), although both measures were subjective and obtained at the same assessment. Regarding objective sleep measures, most polysomnographic parameters did not significantly change; rapid eye movement (REM) sleep percentage increased numerically, but the change was not statistically significant (p = 0.058).Conclusions  In this small uncontrolled study, initiation of istradefylline was associated with improvements in subjective sleep quality, fatigue, and QOL, whereas objective polysomnographic parameters showed limited changes. These findings are exploratory and hypothesis-generating and require confirmation in larger controlled studies.
SN  - 2590-1125
ER  -