Objective: To estimate the prevalence and characterise the extend of sleep dysfunction in early Progressive Supranuclear Palsy and in early Parkinson’s disease among the Indian population.

Background: Sleep disorders in synucleinopathies such as Parkinson’s disease are well described, but we have limited data involving sleep disturbances in other atypical forms of Parkinsonism like Progressive supranuclear palsy, especially in early phase of illness.

Method: A Hospital based, single centre, cross sectional comparative study was done. Patients above 18 years of age and diagnosed with early Parkinson’s disease (Diagnosed as per the UKPDS brain bank diagnostic criteria), possible, probable and suggestive of PSP (PSP-RS, PSP-OM, PSP-Frontal, PSP-PI as per the MDS criteria 2017), with disease duration less than 3 years were recruited. The clinical features including UPDRS were recorded and all patients were subjected to a level 1 PSG. The sleep parameters that were captured included -Total Recording duration (Minutes), Total Sleep Time (Minutes), Wake Duration (Minutes), WASO (wake after sleep onset) Duration (Minutes), N1 duration (Minutes), N2 duration (Minutes), N3 duration (Minutes), REM duration (Minutes), Sleep latency (Minutes), N1 latency (Minutes), N2 latency (Minutes), N3 latency (Minutes), REM latency (Minutes), Sleep efficiency %, wake %, WASO %, N1%, N2%, N3%, REM%, Arousal index, presence of OSA and its severity, presence of periodic leg movement and its severity, presence of REM sleep without atonia and any other parasomnias

Results: 48 patients with early PD and PSP were recruited (30 PD and 18 PSP). The onset of motor symptoms was within 3 years at the time of PSG study. The most common sleep abnormalities were OSA and sleep fragmentation (77% for both) which were noted almost equally in early PD and PSP. Reduced sleep efficiency (less than 85%) was seen in 75% (89% of PSP and 67% of PD). Significant periodic limb movements were noted in 40%; noted almost equally among PD and PSP cases. REM sleep behavioural disturbances were noted in 8.3% (10% of PD and 5.6% of PSP)

Conclusion: Sleep alterations occur even in the early stages of PD and PSP. Early detection can help to manage the symptoms better and improve the quality of life

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-dysfunction-and-its-clinical-and-video-polysomnographic-correlates-in-patients-with-early-parkinsons-disease-in-comparison-with-early-progressive-supranuclear-palsy/