Characterization of Sleep Structure and Autonomic Dysfunction in REM Sleep Behavior Disorder
Nicla Mandas1,2, Maximiliano Mollura3, Giulia Baldazzi2,4
1Hadron AcademyIstituto Universitario di Studi Superiori, IUSS 27100 Pavia Italy.
IEEE Open Journal of Engineering in Medicine and Biology
|November 19, 2024
Summary
REM Sleep Behavior Disorder (RBD) patients exhibit autonomic dysfunction and fragmented sleep. Co-occurring Parkinson's disease (PD) may paradoxically improve sleep continuity despite lower heart rate variability.
Area of Science:
- Neurology
- Sleep Medicine
- Autonomic Neuroscience
Background:
- REM Sleep Behavior Disorder (RBD) is a parasomnia linked to a high risk of developing alpha-synucleinopathies like Parkinson's disease (PD).
- Autonomic dysfunction is increasingly recognized as a prodromal feature of synucleinopathies.
Purpose of the Study:
- To investigate autonomic dysfunction in RBD patients, with and without PD.
- To assess sleep structure and autonomic nervous system activity across sleep stages in these groups.
Main Methods:
- Utilized an innovative framework combining Markov chain sleep transition modeling.
- Employed point-process analysis of heart rate variability (HRV) for instantaneous autonomic state assessment.
Main Results:
- RBD groups displayed lower HRV and increased transitions to lighter sleep stages compared to controls.
- RBD patients with PD showed even lower HRV but improved sleep continuity.
Conclusions:
- RBD patients experience sleep fragmentation and generalized autonomic dysfunction due to reduced autonomic activation.
- Concomitant PD may improve sleep quality in RBD, potentially by alleviating sleep-related symptoms.
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