Objective: Determine relationships between functional mobility and slow wave sleep (non-REM stage 3; N3) in Parkinson’s disease (PD).

Background: Sleep disturbance is a common non-motor feature of PD, and meta-analysis of polysomnographic studies has shown reduced slow wave sleep in PD relative to controls. N3 is the slow wave stage of non-rapid eye movement sleep and a marker of restorative sleep. In PD, lower slow wave activity has been associated with faster longitudinal motor progression, while greater slow wave sleep has been associated with better cognitive performance. Timed Up and Go (TUG) is a valid and reliable clinical measure in PD that captures sit-to-stand transfer, walking, turning, and sitting, thereby reflecting functional mobility and fall risk. Whether objectively measured N3 is associated with TUG performance in PD remains unknown.

Method: Relationships between TUG and N3 percentage were evaluated cross-sectionally in 57 participants with PD. TUG was completed in a clinical setting. Sleep was measured with laboratory-based polysomnography (PSG). TUG and N3% were adjusted for age and sex with studentized residuals used to evaluate Pearson correlation coefficients.

Results: The sample of PD participants (n = 57) included men (n = 41) and women (n = 16) ranging from 45 to 81 years of age (mean 68.3 ± 8.4). There was a moderate, negative association between sex-and age-adjusted TUG and N3% that was statistically significant (r = -0.353, 95% CI -0.562 to -0.102, p = 0.007). This relationship indicates that less deep sleep is associated with impaired functional mobility.

Conclusion: Longer TUG completion time was significantly associated with lower N3 sleep percentage in PD, and this relationship persisted after adjustment for age and sex. These findings suggest that reduced slow wave sleep is associated with poorer functional mobility in PD and may reflect a clinically meaningful relationship between sleep architecture and mobility performance. Further study is needed to clarify the mechanisms, directionality, and clinical implications of this association.

References: – Mollinedo, I., & Ma Cancela, J. (2020). Evaluation of the psychometric properties and clinical applications of the Timed Up and Go test in Parkinson disease: a systematic review. Journal of exercise rehabilitation, 16(4), 302–312. https://doi.org/10.12965/jer.2040532.266
– Nocera, J. R., Stegemöller, E. L., Malaty, I. A., Okun, M. S., Marsiske, M., Hass, C. J., & National Parkinson Foundation Quality Improvement Initiative Investigators (2013). Using the Timed Up & Go test in a clinical setting to predict falling in Parkinson’s disease. Archives of physical medicine and rehabilitation, 94(7), 1300–1305. https://doi.org/10.1016/j.apmr.2013.02.020
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– Wood KH, Memon AA, Memon RA, Joop A, Pilkington J, Catiul C, Gerstenecker A, Triebel K, Cutter G, Bamman MM, Miocinovic S, Amara AW. Slow Wave Sleep and EEG Delta Spectral Power are Associated with Cognitive Function in Parkinson’s Disease. J Parkinsons Dis. 2021;11(2):703-714. doi: 10.3233/JPD-202215. PMID: 33361608; PMCID: PMC8058231.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/reduced-slow-wave-sleep-is-associated-with-mobility-impairment-in-people-with-parkinsons-disease/