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Sleep microstructure in Parkinson's disease: cycling alternating pattern (CAP) as a sensitive marker of early NREM sleep instability.
Sleep Med 2019SM

Abstract

BACKGROUND

Sleep disorders are frequent in Parkinson's disease (PD). Apart from the occurrence of REM behavior disorders, in the early phase of the disease standard sleep macrostructure evaluation was inconclusive.

OBJECTIVE

We analyzed non-rapid eye movement (NREM) sleep microstructure (CAP) in a group of PD patients to provide an objective measure of sleep disruption.

METHODS

We recruited 31 PD patients [mean age 59.5 ± 12.4 years; mean Hoehn-Yahr (H-Y) stage: 3.4 ± 1.8] and 34 age-matched non-parkinsonian subjects (mean age 61.5 ± 15.2 years) as a control group. All patients underwent full-night laboratory polysomnography (PSG). Conventional sleep macro/microstructure analysis was performed. Patients were then divided into two groups: group 1 (H-Y stage ≤ 2) and group 2 (H-Y stage ≥ 3).

RESULTS

In group 2 PD patients compared to controls, alterations of both sleep macrostructure and microstructure were found. The PD subgroup with milder disease (group 1) presented sleep macrostructure, movements and respiratory parameters not significantly different from controls, although their CAP rate was significantly higher and the proportion of the A1 phase of CAP was reduced (p = 0.03). Multivariate logistic regression showed that disease duration, disease severity, and arousal index emerged as independent predictive factors for CAP rate ≥55% and the A1 phase of CAP ≤40% (p < 0.05).

CONCLUSION

The main result of our study consists in the disclosure of altered NREM sleep microstructure in PD even at an early stage of the disease, suggesting an early alteration of the central pathways involved in the NREM sleep building-up and stability.

Authors+Show Affiliations

Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, VB, Italy; Department of Neurosciences, University of Turin, Turin, Italy.Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, VB, Italy.Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, VB, Italy.Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, VB, Italy.Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, VB, Italy.Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, VB, Italy.Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, VB, Italy; Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy. Electronic address: cremaz@hotmail.it.Department of Neurosciences, University of Turin, Turin, Italy.Department of Neurosciences, University of Turin, Turin, Italy.Istituto Auxologico Italiano, IRCCS, Department of Neurology and Neurorehabilitation, San Giuseppe Hospital, Piancavallo, VB, Italy; Department of Neurosciences, University of Turin, Turin, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31307885

Citation

Priano, Lorenzo, et al. "Sleep Microstructure in Parkinson's Disease: Cycling Alternating Pattern (CAP) as a Sensitive Marker of Early NREM Sleep Instability." Sleep Medicine, 2019.
Priano L, Bigoni M, Albani G, et al. Sleep microstructure in Parkinson's disease: cycling alternating pattern (CAP) as a sensitive marker of early NREM sleep instability. Sleep Med. 2019.
Priano, L., Bigoni, M., Albani, G., Sellitti, L., Giacomotti, E., Picconi, R., ... Mauro, A. (2019). Sleep microstructure in Parkinson's disease: cycling alternating pattern (CAP) as a sensitive marker of early NREM sleep instability. Sleep Medicine, doi:10.1016/j.sleep.2019.03.025.
Priano L, et al. Sleep Microstructure in Parkinson's Disease: Cycling Alternating Pattern (CAP) as a Sensitive Marker of Early NREM Sleep Instability. Sleep Med. 2019 Apr 20; PubMed PMID: 31307885.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sleep microstructure in Parkinson's disease: cycling alternating pattern (CAP) as a sensitive marker of early NREM sleep instability. AU - Priano,Lorenzo, AU - Bigoni,Matteo, AU - Albani,Giovanni, AU - Sellitti,Luigi, AU - Giacomotti,Emanuela, AU - Picconi,Roberto, AU - Cremascoli,Riccardo, AU - Zibetti,Maurizio, AU - Lopiano,Leonardo, AU - Mauro,Alessandro, Y1 - 2019/04/20/ PY - 2019/01/06/received PY - 2019/03/26/revised PY - 2019/03/27/accepted PY - 2019/7/17/entrez KW - Cycling alternating pattern KW - NREM sleep KW - Parkinson's disease KW - Sleep KW - Sleep microstructure JF - Sleep medicine JO - Sleep Med. N2 - BACKGROUND: Sleep disorders are frequent in Parkinson's disease (PD). Apart from the occurrence of REM behavior disorders, in the early phase of the disease standard sleep macrostructure evaluation was inconclusive. OBJECTIVE: We analyzed non-rapid eye movement (NREM) sleep microstructure (CAP) in a group of PD patients to provide an objective measure of sleep disruption. METHODS: We recruited 31 PD patients [mean age 59.5 ± 12.4 years; mean Hoehn-Yahr (H-Y) stage: 3.4 ± 1.8] and 34 age-matched non-parkinsonian subjects (mean age 61.5 ± 15.2 years) as a control group. All patients underwent full-night laboratory polysomnography (PSG). Conventional sleep macro/microstructure analysis was performed. Patients were then divided into two groups: group 1 (H-Y stage ≤ 2) and group 2 (H-Y stage ≥ 3). RESULTS: In group 2 PD patients compared to controls, alterations of both sleep macrostructure and microstructure were found. The PD subgroup with milder disease (group 1) presented sleep macrostructure, movements and respiratory parameters not significantly different from controls, although their CAP rate was significantly higher and the proportion of the A1 phase of CAP was reduced (p = 0.03). Multivariate logistic regression showed that disease duration, disease severity, and arousal index emerged as independent predictive factors for CAP rate ≥55% and the A1 phase of CAP ≤40% (p < 0.05). CONCLUSION: The main result of our study consists in the disclosure of altered NREM sleep microstructure in PD even at an early stage of the disease, suggesting an early alteration of the central pathways involved in the NREM sleep building-up and stability. SN - 1878-5506 UR - https://www.unboundmedicine.com/medline/citation/31307885/Sleep_microstructure_in_Parkinson's_disease:_cycling_alternating_pattern_(CAP)_as_a_sensitive_marker_of_early_NREM_sleep_instability L2 - https://linkinghub.elsevier.com/retrieve/pii/S1389-9457(19)30115-7 DB - PRIME DP - Unbound Medicine ER -