Objective: To evaluate subjective and objective measures of sleep disturbance in an incident PD cohort over longitudinal follow-up.

Background: Sleep disturbance is widely recognised as a salient non-motor symptom in PD. However, data regarding the extent of abnormalities are conflicting and there is a dearth of literature interrogating their evolution as the disease progresses. Initial data published from our group found increased daytime naps as the only significant difference between PD patients and controls when evaluated at diagnosis. We sought to establish if subjective and objective markers of sleep disturbance evolve with disease progression.

Methods: Patients and age-matched healthy controls were recruited from an incident cohort as part of the ICICLE-PD study. Patients and controls completed 14 days of sleep diaries, with contemporaneous wrist actigraphy to assess circadian rhythm and total sleep time. Patients also completed overnight home sleep respiratory monitoring and three nights of lower limb actigraphy. Evaluations took place at baseline, 18 months and 36months; 54 month assessment is partially complete and ongoing. Patients could opt to complete some or all elements of the evaluation.

Results: At baseline, 106 patients and 99 controls participated in some or all elements of sleep assessment; 63 patients and 51 controls at 18 months; 45 patients and 41 controls at 36 months. To date, 18 patients have undergone assessment at 54 months. At baseline, 18 and 36 months, frequency of daytime naps was greater in PD subjects than controls (p=0.003; p=0.042; p=0.014). However the amount of daytime naps did not increase significantly over time. Nocturnal awakenings increased significantly in PD patients over time (p=0.005), paralleled by an increased actigraphic sleep fragmentation index (p=0.041). Control subjects had significantly more robust actigraphic measures of sleep-wake cycle stability at serial timepoints. A trend to increased periodic limb movements in sleep (p=0.066) was seen between baseline and 18 months in the PD group.

Conclusions: Serial evaluation of sleep parameters in a PD cohort demonstrates significant evolution in sleep fragmentation measures, not seen in age-matched controls. Controls also demonstrated greater circadian stability over serial assessments. These findings support the concept of sleep disturbance as an integral component of the pathological process as PD advances.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-assessment-of-sleep-in-an-incident-parkinsons-disease-cohort/