Objective: To investigate REM sleep without atonia (RSWA) and other polysomnographic (PSG) alterations in PD and prediagnostic PD.
Background: Sleep disturbances are features of Parkinson’s disease (PD), that can already occur before PD diagnosis (1). The most investigated prodromal PD sleep disorder is REM sleep behavior disorder (RBD) (2). The relation between other PSG variables and the prediagnostic stages of PD, however, is less clear.
Method: In this retrospective study, we included 63 PD subjects (33 subjects that underwent a PSG before PD diagnosis [13 with and 20 without RBD] and 30 subjects that underwent a PSG after PD diagnosis) and 30 controls. PSGs were analyzed for sleep stages, different RSWA variables, body position, arousals, periodic limb movements during sleep and REM density.
Results: Our results show higher subscores of all RSWA variables in subjects with PD and prediagnostic PD (with and without RBD). Total RSWA, tonic RSWA and chin RSWA severity were significant predictors for all (prediagnostic) PD groups. Our study also shows a higher median percentage of nocturnal supine body position in the PD group (78%) and prediagnostic PD groups (46% and 42%), compared to the control group (18%). Supine body position percentage has a positive correlation with time since diagnosis.
Conclusion: These findings suggest that increased total, tonic and chin RSWA as well as nocturnal supine body position are already present in prediagnostic PD, independently of RBD status. Prospective longitudinal studies are necessary to investigate the potential role of these PSG variables as biomarkers for early diagnosis and patient selection in neuroprotective trials.
This abstract has previously been presented at the virtual congres of the European Academy of Neurology 2021 june 19-22.
References: 1. Al-Qassabi A, Fereshtehnejad S-M, Postuma RB. Sleep Disturbances in the Prodromal Stage of Parkinson Disease. Curr Treat Options Neurol. 2017;19:22. 2. Högl B, Stefani A, Videnovic A. Idiopathic REM sleep behaviour disorder and neurodegeneration — an update. Nature Reviews Neurology. 2018;14:40–55.
To cite this abstract in AMA style:
F. Dijkstra, N. Reyn, B. de Bruyn, K. VAN.DEN Bossche, I. de Volder, M. Willemen, M. Viaene, J. Leenders, P. Cras, D. Crosiers. REM sleep without atonia and nocturnal body position in prediagnostic Parkinson’s disease [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/rem-sleep-without-atonia-and-nocturnal-body-position-in-prediagnostic-parkinsons-disease/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/rem-sleep-without-atonia-and-nocturnal-body-position-in-prediagnostic-parkinsons-disease/