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Sleep Architecture in Progressive Supranuclear Palsy: A Video-Polysomnography Study
Srikanth Yadav Boini1, Rohan Mahale1, Seshagiri Donaparthi1
1Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Annals of Indian Academy of Neurology
|December 23, 2022
Summary
Progressive supranuclear palsy (PSP) patients exhibit altered sleep architecture, including reduced total sleep time and efficiency, and increased wakefulness. These changes correlate with neurodegeneration affecting sleep-regulating brain regions.
Area of Science:
- Neurology
- Sleep Medicine
- Neurodegeneration
Background:
- Sleep disturbances are common in progressive supranuclear palsy (PSP).
- Overlapping anatomical regions in PSP affect both the disease pathology and the sleep-wake cycle regulation.
- Limited polysomnographic data exists for PSP, indicating altered sleep architecture.
Purpose of the Study:
- To investigate sleep architecture in PSP patients using video-polysomnography (vPSG).
- To correlate sleep alterations with disease severity and duration in PSP.
Main Methods:
- A prospective, cross-sectional, case-control study involving 22 PSP patients and 15 controls.
- Participants underwent clinical assessment, sleep questionnaires, anxiety/depression scales, and overnight vPSG.
- Detailed analysis of sleep architecture from vPSG recordings.
Main Results:
- PSP patients showed significantly reduced total sleep time, sleep efficiency, N2, N3, and REM sleep durations.
- Increased wake duration, wake after sleep onset (WASO), and N1 duration were observed in PSP patients.
- Prolonged N2 and N3 sleep latencies were noted; REM sleep without atonia occurred in some patients.
Conclusions:
- Sleep architecture is significantly altered in PSP, even in early stages.
- Reduced non-REM and REM sleep, decreased sleep efficiency, prolonged latencies, and increased wakefulness characterize PSP sleep.
- These findings align with neurodegenerative changes in brainstem nuclei controlling sleep-wake cycles.
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