Objective: This study used polysomnography (PSG) to examine the relationship between depression in PD and sleep characteristics, particularly (SWA).

Background: Depression and sleep disturbance is two commonly seen non-motor symptoms in patients with Parkinson’s disease (PD) which lead to a substantial reduction in quality of life. The association between depression and sleep disturbances especially changes of slow wave activities(SWA) is uncertain.

Method: After enrollment, 59 PD patients were split into two groups: nd-PD (n=27)(patients with PD with depression) and d-PD (n=32)(patients with PD without depression). Patients had their comprehensive clinical features, objective polysomnography prameters, and demographics evaluated. Comparisons between early and late sleep SWA and overnight SWA decline in different brain regions  spectrum densities of the two groups were particularly analyzed.

Results: Non-rapid eye movement (N3) sleep duration and percentage were greater in the d-PD group than in the nd-PD group (p=0.032 and p=0.043). N3 duration was linked to depression (p=0.025). Higher SWA (0.5–4Hz) was observed in the frontal and central regions, higher low-SWA (0.5-2Hz) was observed across the brain, in the central and occipital regions, and during late sleep, there was higher high-SWA (2-4Hz) in the frontal region in the d-PD group. During early sleep, there was also higher low-SWA (0.5-2Hz) in the occipital region. Patients in d-PD group exhibited notably reduced overnight high-SWA (2-4Hz) decline (Δhigh-SWA(2-4Hz)) throughout the entire brain and occipital region in contrast to those without depression. The results of a logistic regression analysis showed that in patients with PD, after adjusting the potential confounders, Δhigh-SWA(2-4Hz) in the occipital region were still associated with depression (p=0.047).

Conclusion: PD patients with depression have impaired slow wave sleep, exhibiting as increased N3 duration and percentage, higher SWA spectral density, and reduced overnight SWA decline. This implies that that synaptic strength reduction during slow wave sleep and impaired synaptic homeostasis regulation may be associated with depression in PD patients.. A reduced high-frequency SWA (2-4Hz) overnight decline in the occipital region may serve as a novel electrophysiological biomarker for indicating depression in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/changes-in-slow-wave-sleep-characteristics-in-parkinsons-disease-patients-with-depression/