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

Julie Anja Engelhard Christensen, Poul Jennum, Henriette Koch, Rune Frandsen, Marielle Zoetmulder, Lars Johan Arvastson, Søren Rahn Christensen, Helge Bjarup Dissing Sørensen

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Abstract

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.
Original languageEnglish
JournalClinical Neurophysiology
Volume127
Issue number1
Pages (from-to)537–543
ISSN1388-2457
DOIs
Publication statusPublished - 2016

Keywords

  • Neurology (clinical)
  • Neurology
  • Physiology (medical)
  • Sensory Systems
  • Data-driven detection
  • Parkinson's disease
  • Polysomnography
  • Rapid eye movement sleep behavior disorder
  • Sleep transitions

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