Objective: To investigate associations between inflammatory blood markers and sleep quality in Parkinson’s Disease (PD) and explore whether biological sex influences these associations.

Background: Inflammation contributes to the pathogenesis of PD and its non-motor symptoms, including sleep problems¹. Research across various populations links systemic inflammation to sleep problems and suggests that sex may influence these associations². However, studies on systemic inflammation and sleep problems in PD are lacking and yield conflicting results^3-6, with limited research exploring whether sex modulates these relationships.

Method: Data from 35 people with PD and sleep complaints (age= 65.9±9.7; F= 14; PD duration= 7.1±5.9y; PD Sleep Scale 2[PDSS-2]= 22.3±10.1) tested “On” medications by blinded assessors were analyzed⁷. Different aspects of sleep quality were assessed subjectively with the PDSS-2 and objectively with actigraphy (total sleep time, sleep efficiency and fragmentation, wake after sleep onset) over a period of ~seven nights. Concentrations of interleukin (Il)1β, Il6, Il10, tumour necrosis factor (TNF)α, and C-reactive protein (CRP) were measured from sera collected in the morning after a 12h fasting period. Associations were examined with generalized regressions using sex and its interaction. The robustness of significant associations was assessed by adjusting p-values for multiple comparisons and including age, disease duration, and levodopa equivalent daily dose in the model.

Results: No significant associations were found between blood markers and sleep quality, nor were there significant sex differences in blood marker concentrations. Only in females, CRP, TNFα and Il10 were significantly associated with PDSS-2 (R²= 0.38; CRP*Sex: p= 0.005; Female, β= 3.73e-5, p< 0.000), sleep efficiency (R²= 0.27; TNFα*Sex: p< 0.000; Female, β= -0.74, p= 0.003) and fragmentation (R²= 0.17; Il10*Sex: p< 0.037; Female, β= -0.08, p= 0.034), respectively. Only the sleep efficiency-TNFα association survived multiple comparison and covariates adjustments.

Conclusion: Our preliminary results suggest that inflammation is not linked to subjective and objective (actigraphy) sleep quality in PD, although sex may influence some of these associations. Our results warrant confirmation in larger and longitudinal polysomnography studies⁷.

References: 1. Tansey MG, Wallings RL, Houser MC, Herrick MK, Keating CE, Joers V. Inflammation and immune dysfunction in Parkinson disease. Nature Reviews Immunology. Nov 2022;22(11):657-673.
2. Irwin MR. Sleep and inflammation: partners in sickness and in health. Nature Reviews Immunology. 2019/11/01 2019;19(11):702-715.
3. Kaminska M, O’Sullivan M, Mery V, et al. Inflammatory markers and BDNF in obstructive sleep apnea (OSA) in Parkinson’s disease (PD). Sleep medicine. 2022;90:258-261.
4. Kim R, Kim H-J, Shin JH, Lee CY, Jeon SH, Jeon B. Serum Inflammatory Markers and Progression of Nonmotor Symptoms in Early Parkinson’s Disease. Movement Disorders. 2022/07/01 2022;37(7):1535-1541.
5. Menza M, DeFronzo Dobkin R, Marin H, et al. The Role of Inflammatory Cytokines in Cognition and Other Non-Motor Symptoms of Parkinson’s Disease. Psychosomatics. 2010/11/01/ 2010;51(6):474-479.
6. Carlisle SM, Qin H, Hendrickson RC, et al. Sex-based differences in the activation of peripheral blood monocytes in early Parkinson disease. npj Parkinson’s Disease. 2021/04/13 2021;7(1):36.
7. Cristini J, Potvin-Desrochers A, Seo F, et al. The Effect of Different Types of Exercise on Sleep Quality and Architecture in Parkinson Disease: A Single-Blinded Randomized Clinical Trial Protocol. Physical Therapy. 2024;104(1):pzad073.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/associations-between-inflammation-and-sleep-quality-in-parkinsons-disease-exploring-the-potential-influence-of-sex/