Overnight Distribution of REM Sleep Features in People with Parkinson's Disease (PD) and Non-PD Controls

Andrew Dagay, Shani Oz, Shlomit Katzav, Danielle Wasserman, Riva Tauman, Avner Thaler, Nir Giladi, Anat Mirelman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Rapid eye movement (REM) sleep behavior disorder (RBD) is a leading predictor of Parkinson's disease (PD). Diagnosis is performed in the sleep laboratory by detecting pathological REM sleep without atonia (RSWA). The evidence on the overnight distribution of RSWA% is conflicting. Objective: To investigate the temporal distribution of the number of ocular movements per REM sleep minute (REM density), and RSWA% in people with PD and non-PD controls. Methods: All participants underwent a single overnight evaluation in a sleep laboratory. Clinical evaluation was performed on a separate day. REM density and RSWA% were compared between PD and controls both across four sleep periods and individual REM cycles. Results: A total of 51 participants with recorded RSWA in polysomnography laboratory were included, 28 with PD aged 64±9 years with a disease duration of 3.3±2.9 years, and 23 controls aged 55±8 years. People with PD had lower REM density and higher RSWA% compared to controls. As expected, REM density was higher towards the morning. In contrast, RSWA% was equally distributed across the night, for both PD and controls. Conclusions: PD pathology affects REM sleep features, but not the overnight distribution of those features. While REM density increased towards the end of the night, RSWA% was equally distributed across the night for both PD and controls. Our findings have clinical implications for diagnosing RBD, as quantification of RSWA% in any sleep cycle is sufficient for reliably evaluating total RSWA% and reduced REM density may be a marker of PD.

Original languageEnglish
Pages (from-to)1213-1223
Number of pages11
JournalJournal of Parkinson's Disease
Volume13
Issue number7
DOIs
StatePublished - 3 Nov 2023

Keywords

  • Parkinson's disease
  • REM density
  • REM sleep without atonia
  • rapid eye movement sleep behavior disorder
  • sleep
  • sleep disorders

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