Objective: To characterize life course sleep duration trajectories and examine their associations with PD risk and age at onset (AAO).
Background: Sleep disturbances could be both prodromal marker and risk factor for PD. Studying early-life sleep trajectories and their connection to PD onset is critical for disentangling the role of sleep disturbances as prodromal or risk factors for PD, offering opportunities for early detection and intervention.
Method: We analyzed data from two ongoing online cohorts: Parkinson’s Progression Markers Initiative (PPMI)-Online (discovery cohort; initiated in 2021) and Fox Insight (FI; validation cohort; initiated in 2018). Participants self-reported sleep duration across different life stages (ages 18 to 80+ in PPMI-Online; ages 12 to 66+ in FI) with PD-related follow-ups every three months. Sleep trajectories were identified using latent class growth analysis (LCGA). Logistic and linear regression models were used to assess associations between sleep duration trajectories with PD risk and AAO, adjusting for demographics, lifestyle factors, and comorbidities.
Results: The combined sample included 5,660 individuals with PD and 10,245 without PD from PPMI-Online, and 1,929 PD participants from FI (age at sleep report 67.2±7.83 years; 9,735 (54.6%) female). LCGA identified nine sleep trajectories in PPMI-Online, stable in early adulthood but diverging in midlife (stable, increasing, decreasing). Midlife sleep reductions (6-7 to ≤5-6 hours/day: OR = 1.90, 95% CI 1.61-2.24, P < .001; 7-8 to ≤6-7 hours/day: OR = 1.64, 95% CI 1.40-1.91, P < .001) and consistent short sleep (<=6 hours/day throughout adulthood: OR = 1.41, 95% CI 1.19-1.67, P < .001) demonstrated increased PD risk. Short sleep in early adulthood or midlife also had earlier AAO. The strongest effects were seen in those with ≤6 hours/day throughout adulthood (PPMI-Online: β = -2.45 years, 95% CI -3.33 to -1.56, P <.001) and those with a continuous decrease since adolescence (FI: β = -4.23 years, 95% CI -5.52 to -2.93, P < .001). These effects were independent of RBD.
Conclusion: Self-reported short sleep in early adulthood and midlife sleep reductions are associated with increased PD risk and earlier AAO. Self-perceived midlife sleep reduction may be a marker for future PD. Persons with chronic short sleep may be candidates for preventive intervention.
Figure 1. Flow Diagram of Study Participants
Figure 2. Trajectories and PD Risk in PPMI-Online
Figure 3. Trajectories and PD AAO in PPMI-Online
Figure 4. Trajectories and PD AAO in FI
Table 1. Demographic and Clinical Characteristics
To cite this abstract in AMA style:
Y. Fang, R. Hardy, K. Yaffe, S. Little, C. Tanner, Y. Leng. Life Course Sleep Duration Trajectories and Risk and Age at Onset of Parkinson’s Disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/life-course-sleep-duration-trajectories-and-risk-and-age-at-onset-of-parkinsons-disease/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/life-course-sleep-duration-trajectories-and-risk-and-age-at-onset-of-parkinsons-disease/