SLEEP AND CIRCADIAN RHYTHM REGULATION IN EARLY PARKINSON'S DISEASE. Issue 11 (14th October 2015)

• Record Type: Journal Article
• Authors: Breen, David; Vuono, Romina; Nawarathna, Upekshani; Fisher, Kate; Shneerson, John; Reddy, Akhilesh; Barker, Roger
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 86:Issue 11(2015)
• Page Start: e4
• Page End: e4
• Publication Date: 2015-10-14
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2015-312379.22
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Aim: Sleep disturbances are recognised as a common non-motor complaint in Parkinson's disease but their aetiology is poorly understood. We set out to define the sleep and circadian phenotype of early-stage Parkinson's disease patients. Methods: We began by assessing the sleep characteristics of a large population-representative incident Parkinson's disease cohort (n=239) at the University of Cambridge. We went on to carry out more comprehensive case-control sleep assessments in a subgroup of these patients (n=30) and matched controls (n=15). Outcome measures were 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. Parkinson's disease patients exhibited increased sleep latency, reduced sleep efficiency and reduced REM sleep. In addition, there was a sustained elevation of serum cortisol levels, reduced circulating melatonin levels, and altered Bmal1 expression in Parkinson's disease patients compared to controls. Conclusions: The sleep dysfunction seen in early Parkinson's disease may reflect a more fundamental pathology in the molecular clock underlying circadian rhythms.