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Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease
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Beyond RBD: covert REM sleep abnormalities in Parkinson's disease.

Saar Lanir-Azaria1,2, Yuval Nir3,4,5,6,7, Riva Tauman8,9

  • 1Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel. saarlan530@gmail.com.

NPJ Parkinson'S Disease
|March 1, 2026
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Summary
This summary is machine-generated.

Subtle REM sleep abnormalities, beyond REM sleep behavior disorder (RBD), are present in early Parkinson's disease (PD). These disruptions correlate with disease progression and impaired motor learning, suggesting potential early diagnostic markers.

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Area of Science:

  • Neuroscience
  • Sleep Medicine
  • Neurology

Background:

  • REM sleep behavior disorder (RBD) is a prodromal marker for Parkinson's disease (PD).
  • It is unclear if RBD represents the full extent of REM sleep pathology in early PD.

Purpose of the Study:

  • To investigate REM sleep abnormalities beyond clinically diagnosed RBD in early, drug-naïve PD patients.
  • To assess the relationship between REM sleep patterns, generalized motor learning (GML), and disease progression.

Main Methods:

  • Overnight polysomnography with high-density EEG (256 channels) in 25 early PD patients and 23 controls.
  • Assessment of REM sleep without atonia (RSWA) and spectral analysis during REM sleep.
  • Evaluation of sleep's impact on overnight generalized motor learning (GML).

Main Results:

  • PD patients showed elevated RSWA, with 36% meeting criteria for excessive RSWA (PD+RSWA).
  • Increased occipital-parietal theta activity during REM sleep in PD+RSWA correlated with disease progression.
  • Sleep benefited GML in all participants, but REM sleep duration negatively correlated with GML benefits in PD patients, especially PD+RSWA.

Conclusions:

  • Subtle REM sleep disruptions, including excessive RSWA and altered theta activity, are present in early PD, extending beyond overt RBD.
  • These REM sleep abnormalities are associated with disease progression and impaired sleep-dependent motor learning.
  • REM sleep disruptions may serve as early neurophysiological markers for PD and potential therapeutic targets.