Objective: To establish whether accelerometry using the Parkinson Kinetigraph (PKG, Global Kinetics) can distinguish between normal and abnormal nocturnal sleep in Parkinson’s disease (PD).

Background: Nocturnal sleep disturbance is common in PD. A simple effective means of detecting abnormal sleep would aid in identifying those who need further investigation. Polysomnography (PSG) is the gold standard for sleep assessment and uses sleep efficiency (SE), Arousal index, Apnoea Hypopnea Index and Periodic Limb Movements/hr and a report that takes into account these scores. Actigraphy has been widely used but has failed to accurately quantify sleep, in part because of the effect of limb movement during sleep.

Methods: We performed simultaneous PSG and PKG measures in 45 subjects, 10 of whom had normal sleep. The PKG scores “periods of immobility” of at least 2 minutes and we used this to develop, amongst other measures, surrogates for SE (percent of attempted sleep time in which the patient was immobile) and fragmentation (the median length of each period of continuous immobility). These are called %time asleep (%TA) and median time immobile (MTI) respectively. We used these to develop a score that clearly differentiated between normal and abnormal sleepers as determined by the PSG report. We then applied this PKG score to 24 age matched subjects without PD and 35 people with PD (PwP) who wore the PKG for 6 nights and responded to various questionnaires including Parkinson’s disease Sleep Scale 2 (PDSS-2). A further 45 PKG were also analysed but without questionnaire.

Results: The PKG score combining the %TA and the MTI predicted normal or abnormal sleep (according to the PSG) with 100% selectivity and sensitivity. In the 24 subjects without PD only 2 had abnormal sleep according to the PKG and one of these gave a history of restless legs. Amongst the PD subjects 28% had normal sleep according to the PKG criteria and in those interviewed, PKG values had a good correlation (r2 = 0.49) with the PDSS2 scale.

Conclusions: The PKG score appears to provide a simple means of detecting normal and abnormal sleep in PD. This is based on a small PSG sample and further analyses are required.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/measurement-of-night-time-sleep-using-an-accelerometry-based-system/