Obstructive sleep apnea, periodic limb movements, and REM sleep without atonia are common in Parkinson's disease and correlate with motor symptom burden

BackgroundSleep disturbances are prevalent and debilitating non-motor symptoms in patients with Parkinson's disease (PD).ObjectiveThis study aimed to explore sleep architecture and the prevalence of polysomnographic (PSG) sleep findings in PD, examining the associations between sleep parameters and other clinical characteristics.MethodsThe study included 97 PD patients (age: 67.1 ± 7.9) and 42 non-PD controls (age: 64.7 ± 9.7). Participants underwent clinical assessment and video-PSG. Sleep parameters, apnea-hypopnea index (AHI), periodic limb movements index (PLMI), and REM sleep without atonia (RSWA) were obtained. General linear models were used to explore interactions between disease duration and sleep variables in predicting PD symptoms.ResultsNearly 94% of PD patients showed at least one video-PSG-assessed sleep finding, including AHI-defined obstructive sleep apnea (OSA), periodic limb movements, and RSWA. Sleep alterations correlated with disease severity, with reduced sleep duration and efficiency, higher sleep latency, and higher AHI being associated with worse PD severity. Sleep efficiency was more strongly associated with motor symptoms and disease severity at longer disease duration, while AHI exhibited a stronger relationship with motor symptoms at shorter disease duration. Finally, PD patients showed significant alterations in sleep macrostructure compared to controls, including reduced sleep duration (d = 0.75) and efficiency (d = 1.15) and decreased percentage of stage 3 non-REM sleep (d = 0.37).ConclusionsThe study showed a high prevalence of video-PSG-defined sleep findings in PD, with interactions between disease duration, sleep efficiency, and AHI. The present results support personalized management of sleep disturbances in PD to potentially improve symptoms and reduce the burden of illness.