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JAMA Neurol. 2014 May;71(5):589-595. doi: 10.1001/jamaneurol.2014.65.

Sleep and circadian rhythm regulation in early Parkinson disease.

Author information

1
John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, England (Breen, Vuono, Fisher, Barker); Respiratory and Sleep Support Centre, Papworth Hospital, Cambridge, England (Nawarathna, Shneerson); Institute of Metabolic Science, University of Cambridge, Cambridge, England (Reddy).
#
Contributed equally

Abstract

IMPORTANCE:

Sleep disturbances are recognized as a common nonmotor complaint in Parkinson disease but their etiology is poorly understood.

OBJECTIVE:

To define the sleep and circadian phenotype of patients with early-stage Parkinson disease.

DESIGN, SETTING, AND PARTICIPANTS:

Initial assessment of sleep characteristics in a large population-representative incident Parkinson disease cohort (N=239) at the University of Cambridge, England, followed by further comprehensive case-control sleep assessments in a subgroup of these patients (n=30) and matched controls (n=15).

MAIN OUTCOMES AND MEASURES:

Sleep diagnoses and sleep architecture based on polysomnography studies, actigraphy assessment, and 24-hour analyses of serum cortisol, melatonin, and peripheral clock gene expression (Bmal1, Per2, and Rev-Erbα).

RESULTS:

Subjective sleep complaints were present in almost half of newly diagnosed patients and correlated significantly with poorer quality of life. Patients with Parkinson disease exhibited increased sleep latency (P = .04), reduced sleep efficiency (P = .008), and reduced rapid eye movement sleep (P = .02). In addition, there was a sustained elevation of serum cortisol levels, reduced circulating melatonin levels, and altered Bmal1 expression in patients with Parkinson disease compared with controls.

CONCLUSIONS AND RELEVANCE:

Sleep dysfunction seen in early Parkinson disease may reflect a more fundamental pathology in the molecular clock underlying circadian rhythms.

PMID:
24687146
PMCID:
PMC4119609
DOI:
10.1001/jamaneurol.2014.65
[Indexed for MEDLINE]
Free PMC Article
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