Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2026

Impact of Sleep Disturbance and Early Morning OFF Symptoms on Health-Related Quality of Life in Advanced Parkinson’s Disease (#239)

Rajesh Pahwa 1 , Irene Malaty 2 , Ray Chaudhuri 3 , Josefa Domingos 4 5 , Marieke Heisen 6 , Pablo Arija 7 , Divya Mohan 8 , Hannah Penton 7 , Maja Kuharic 9 10 , Anjana Lalla 11 , Zachary Baldwin 11 , Anand Shewale 12 , Connie H Van 12 , Theresa Phan 13 , Marco Boeri 8
  1. University of Kansas Medical Center, Kansas City, KS, USA
  2. Department of Neurology, Fixel Institute for Neurological Diseases, Gainesville, FL, USA
  3. Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
  4. Egas Moniz School of Health & Science, Almada, Portugal
  5. Parkinson's Europe, Orpington, UK
  6. Heisen Health, Utrecht, The Netherlands
  7. OPEN Health, The Netherlands
  8. OPEN Health, London, UK
  9. Northwestern University Feinberg School of Medicine, Chicago, IL, USA
  10. BefterHealth Outcomes LLC, Chicago, IL, USA
  11. AbbVie Inc., Irvine, CA, USA
  12. AbbVie Inc. , North Chicago, IL, USA
  13. AbbVie, Mascot, NSW, Australia

Aims: To quantify the impact of sleep disturbance (Sd) and early morning OFF (EMO) symptoms on health-related quality of life (HRQoL) in people with advanced Parkinson’s Disease (PwP).

Methods: Adults (>30 years) with self-reported PD diagnosis for ≥5 years, with ≥2 hours/day of OFF time, on oral PD medications, residing in US or UK, completed an online questionnaire to measure the impact of Sd and EMO on PwP’s HRQoL. Participants rated four health states: A) No Sd or EMO, B) Sd without EMO, C) EMO without Sd, and D) both Sd+EMO, using EQ-5D-5L (utility scored from -0.573 to 1) and EQ-VAS (0 to 100 scale).

Results: Among 75 participants (average age 64.3 years, 9.8 years PD duration, 3.9 OFF hours/day), 96% experienced Sd and 99% experienced EMO at least once in the past week; 38% and 32%, respectively, experiencing them ≥4 times. Over the past year, 49% and 24% had not discussed Sd or EMO with a neurologist or movement disorder specialist. Sd (utility 0.80) or EMO (0.70) was associated with low EQ-5D-5L health-state utility values, with the lowest utility observed when both were present (0.53) compared with no symptoms (0.91). Mean EQ-VAS scores ranged from a mean of 81.01 (no symptoms) to 48.41 (both symptoms) with intermediate scores for Sd (65.85) and EMO (60.07).

Conclusions: Sd and EMO substantially impact PwP’s HRQoL, with EMO having a more detrimental effect. Many PwP do not discuss these symptoms with their HCPs, revealing a need for greater communication and proactive management