@article{9807fb7201694eb8966c88fa38a6ff6c,
title = "Tossing and Turning in Bed: Nocturnal Movements in Parkinson's Disease",
abstract = "Background: Sleep disturbances and nocturnal hypokinesia are common in Parkinson's disease (PD). Recent work using wearable technologies showed fewer nocturnal movements in PD when compared with controls. However, it is unclear how these manifest across the disease spectrum. Objectives: We assessed the prevalence of sleep disturbances and nocturnal hypokinesia in early and advanced PD and their relation to nonmotor symptoms and dopaminergic medication. Methods: A total of 305 patients with PD with diverse disease severity (Hoehn and Yahr [H&Y] stage 1 = 47, H&Y stage 2 = 181, H&Y stage 3 = 77) and 205 healthy controls continuously wore a tri-axial accelerometer on the lower back for at least 2 days. Lying, turning, and upright -time at night were extracted from the acceleration signals. Percent upright time and nighttime walking were classified as sleep interruptions. The number, velocity, time, side, and degree of rotations in bed were used to evaluate nocturnal movements. Results: Nocturnal lying time was similar among all groups (healthy controls, 7.5 ± 1.2 hours; H&Y stage 1, 7.3 ± 0.9 hours; H&Y stage 2, 7.2 ± 1.3 hours; H&Y stage 3, 7.4 ± 1.6 hours; P = 0.501). However, patients with advanced PD had more upright periods, whereas the number and velocity of their turns were reduced (P ≤ 0.021). Recently diagnosed patients (<1 year from diagnosis) were similar to controls in the number of nocturnal turns (P = 0.148), but showed longer turning time (P = 0.001) and reduced turn magnitude (P = 0.002). Reduced nocturnal movements were associated with increased PD motor severity and worse dysautonomia and cognition and with dopaminergic medication. Conclusions: Using wearable sensors for continuous monitoring of movement at night may offer an unbiased measure of disease severity that could enhance optimal nighttime dopaminergic treatment and utilization of turning strategies.",
keywords = "Parkinson's disease, accelerometers, nocturnal movements, sleep, wearable sensors",
author = "Anat Mirelman and Inbar Hillel and Lynn Rochester and {Del Din}, Silvia and Bloem, {Bastiaan R.} and Laura Avanzino and Alice Nieuwboer and Inbal Maidan and Talia Herman and Avner Thaler and Tanya Gurevich and Meir Kestenbaum and Avi Orr-Urtreger and Mirek Brys and Cedarbaum, {Jesse M.} and Nir Giladi and Hausdorff, {Jeffrey M.}",
note = "Publisher Copyright: {\textcopyright} 2020 International Parkinson and Movement Disorder Society",
year = "2020",
month = jun,
day = "1",
doi = "10.1002/mds.28006",
language = "אנגלית",
volume = "35",
pages = "959--968",
journal = "Movement Disorders",
issn = "0885-3185",
publisher = "John Wiley & Sons Inc.",
number = "6",
}