Sleep stability and transitions in patients with idiopathic REM sleep behavior disorder and patients with Parkinson's disease

TY - JOUR

T1 - Sleep stability and transitions in patients with idiopathic REM sleep behavior disorder and patients with Parkinson's disease

AU - Christensen, Julie Anja Engelhard

AU - Jennum, Poul

AU - Koch, Henriette

AU - Frandsen, Rune

AU - Zoetmulder, Marielle

AU - Arvastson, Lars

AU - Christensen, Søren Rahn

AU - Sorensen, Helge Bjarrup Dissing

N1 - Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - OBJECTIVE: Patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) are at high risk of developing Parkinson's disease (PD). As wake/sleep-regulation is thought to involve neurons located in the brainstem and hypothalamic areas, we hypothesize that the neurodegeneration in iRBD/PD is likely to affect wake/sleep and REM/non-REM (NREM) sleep transitions.METHODS: We determined the frequency of wake/sleep and REM/NREM sleep transitions and the stability of wake (W), REM and NREM sleep as measured by polysomnography (PSG) in 27 patients with PD, 23 patients with iRBD, 25 patients with periodic leg movement disorder (PLMD) and 23 controls. Measures were computed based on manual scorings and data-driven labeled sleep staging.RESULTS: Patients with PD showed significantly lower REM stability than controls and patients with PLMD. Patients with iRBD had significantly lower REM stability compared with controls. Patients with PD and RBD showed significantly lower NREM stability and significantly more REM/NREM transitions than controls.CONCLUSIONS: We conclude that W, NREM and REM stability and transitions are progressively affected in iRBD and PD, probably reflecting the successive involvement of brain stem areas from early on in the disease.SIGNIFICANCE: Sleep stability and transitions determined by a data-driven approach could support the evaluation of iRBD and PD patients.

AB - OBJECTIVE: Patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) are at high risk of developing Parkinson's disease (PD). As wake/sleep-regulation is thought to involve neurons located in the brainstem and hypothalamic areas, we hypothesize that the neurodegeneration in iRBD/PD is likely to affect wake/sleep and REM/non-REM (NREM) sleep transitions.METHODS: We determined the frequency of wake/sleep and REM/NREM sleep transitions and the stability of wake (W), REM and NREM sleep as measured by polysomnography (PSG) in 27 patients with PD, 23 patients with iRBD, 25 patients with periodic leg movement disorder (PLMD) and 23 controls. Measures were computed based on manual scorings and data-driven labeled sleep staging.RESULTS: Patients with PD showed significantly lower REM stability than controls and patients with PLMD. Patients with iRBD had significantly lower REM stability compared with controls. Patients with PD and RBD showed significantly lower NREM stability and significantly more REM/NREM transitions than controls.CONCLUSIONS: We conclude that W, NREM and REM stability and transitions are progressively affected in iRBD and PD, probably reflecting the successive involvement of brain stem areas from early on in the disease.SIGNIFICANCE: Sleep stability and transitions determined by a data-driven approach could support the evaluation of iRBD and PD patients.

KW - Aged

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Parkinson Disease

KW - Polysomnography

KW - REM Sleep Behavior Disorder

KW - Sleep Stages

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.clinph.2015.03.006

DO - 10.1016/j.clinph.2015.03.006

M3 - Journal article

C2 - 25843013

SN - 1388-2457

VL - 127

SP - 537

EP - 543

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

IS - 1

ER -