Category: Parkinson's Disease: Non-Motor Symptoms
Objective: To describe sleep characteristics and quality in GBA, LRRK2 and non-genetic idiopathic Parkinson disease.
Background: Sleep disturbances are one of the most common non-motor symptoms in Parkinson disease (PD) and greatly impact quality of life. Genetic variants of PD as a group may vary in their clinical progression, including demonstrating differences in sleep disturbances. While previous studies have largely focused on REM Sleep Behavior Disorder (RBD) in LRRK2 and GBA PD, we evaluated additional sleep features in these cohorts.
Method: PD participants in genetic research were identified as harboring a GBA or LRRK2 variant, or neither, considered “idiopathic PD” (IPD). This cohort was enrolled in a pilot study. Subjective sleep problems were evaluated by questionnaires: Parkinson’s Disease Sleep Scale 2 (PDSS-2), Epworth Sleepiness Scale (ESS), Mayo Sleep Questionnaire (MSQ). Objective sleep quality was measured with actigraphy via wrist actigraph for 1 week duration.
Results: Among 48 individuals with PD: 12 GBA variants, 18 LRRK2 G2019S, and 18 IPD. GBA carriers were younger, average 59.4 years, than LRRK2 73.5 and IPD 71.7 (p=0.009). Average duration of disease for GBA was 6.8 years, LRRK2 9.8, IPD 10.8 (p=0.22). As measured by positive response to question 1 in the MSQ, the majority of GBA (54.6%) and IPD (82.4%) reported sleep enactment behaviors suggestive of RBD, but only 12.5% of LRRK2 did (p<0.001). Poor sleep, as characterized by PDSS-2 score >=15, was present in 41.7% GBA, 50% LRRK2 and 62.1% IPD. Severe excessive daytime sleepiness, measured by ESS >=16, was present in a minority: GBA 16.7%, LRRK2 16.7%, IPD 11.1% (p=1). Groups did not differ in objective measures of sleep quality assessed by actigraphy: Sleep efficiency: GBA 84%, LRRK2 87%, IPD 84% (p=0.358) and Sleep time: GBA 372 min, LRRK2 409, IPD 355 (p=0.180).
Conclusion: As anticipated, LRRK2 PD had less report of RBD than GBA PD and IPD. However, LRRK2 PD did not have significantly less report of other sleep disturbances. This suggests that interventions are needed to improve sleep across all genetic groups, and sleep problems extend beyond RBD. Interpretation in our study was limited by sample size and larger studies are warranted with additional measures, including with polysomnography.
To cite this abstract in AMA style:A. Yoo, R. Ortega, D. Raymond, B. Plitnick, M. Markgraf, J. Liang, M. Rawal, A. Wise, M. Pullman, K. Leaver, V. Katsnelson, J. Miravite, V. Shanker, M. Swan, M. Figueiro, S. Bressman, R. Saunders-Pullman. Sleep quality in GBA, LRRK2 and idiopathic Parkinson disease [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/sleep-quality-in-gba-lrrk2-and-idiopathic-parkinson-disease/. Accessed September 28, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-quality-in-gba-lrrk2-and-idiopathic-parkinson-disease/