Objective: To compare sleep stability, arousals and sleep cycle structure between two sets of diagnosis: iRBD vs PD vs DLB; patients with RBD (RBD+) vs patients without RBD (RBD-).

Background: iRBD,  PD and DLB patients share similar REM sleep symptoms, caused by derangement of mesopontine regions. Less is known regarding sleep stability and transition, arousals and sleep cycles structure, there being no studies comparing all three disorders.Because not all PD and DLB patients have RBD, it is also important to understand to which categorical division sleep structure changes should be ascribed to: presence/absence of RBD versus disease type (iRBD, PD, DLB)

Method: All patients underwent one-night video-polysomnography. We assessed the number of shifts between Wake and REM, Wake and NREM, REM and NREM (transition measures) and the passages within the same sleep stage (stability measures), arousals, the total number of sleep cycles, and N3 and R stages duration in each cycle. These variables were compared between two sets of groups (PD vs. DLB vs. iRBD and RDB+ vs. RBD-).

Results: Disease type analysis included 54 PD, 24 DLB and 21 iRBD patients. RBD related analysis included 54 RBD+ and 22 RBD (PSG was inconclusive regarding RBD in 23 patients, due to REM sleep absence, who were excluded from this analysis). There were no significant differences regarding sleep stability between categories in either set. Arousal indices in N1 and N2 stages were significantly higher in PD compared to iRBD. Twenty-four percent of the sample did not have any sleep cycle, another 54.24% had less than 3 cycles. PD had significantly less cycles than iRBD patients. There was no effect of group or time of night in REM or N3 duration.
There were no significant differences in any variable between RBD+ and RBD-.

Conclusion: Our results suggest a similar disturbance in stability/transition measures in all three disorders. Arousals and disturbance in sleep cycling was higher in PD patients, suggesting an increased susceptibility in this group. The presence of RBD did not differentiate between patients regarding any variable

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-stability-arousals-and-cycle-structure-in-alfa-synucleinopathies-a-comparative-study-between-isolated-rem-sleep-behaviour-disorder-irbd-parkinsons-disease-pd-and-dementia-with-le/