Increased REM sleep without atonia variable subscores are present in prediagnostic Parkinson’s disease (PD), independent of REM sleep behavior disorder status (RBD), according to findings presented at MDS Virtual Congress 2021.

Researchers aimed to investigate the role of REM sleep without atonia in addition to other polysomnographic alterations, such as nocturnal supine body position, in PD and prediagnostic PD through this retrospective study.

“The most investigated prodromal PD sleep disorder is REM sleep behavior disorder. The relation between other PSG (polysomnographic) variables and the prediagnostic stages of PD, however, is less clear,” wrote Femke Dijkstra, MSc, University Hospital of Antwerp, Antwerpen, Belgium and co researchers, highlighting that sleep disturbances are common features of PD that can predate diagnosis.

A total of 63 patients with PD and 30 controls were included in this study. Of the participants with PD, 33 underwent polysomnography prior to PD diagnosis, and 30 underwent polysomnography following diagnosis. The polysomnographic assessments analyzed various REM sleep without atonia variables, sleep stages, REM density, body position, periodic limb movements during sleep, and arousals.

Patients with PD and prediagnostic PD showed higher subscores of all REM sleep without atonia variables, regardless of RBD status.

Researchers found significant predicators for the PD groups included total REM sleep without atonia, tonic REM sleep without atonia, and chin REM sleep without atonia. The PD and prediagnostic PD groups also had higher percentages of nocturnal supine body position when compared to the control group.

“These findings suggest that increased total, tonic and chin RSWA as well as nocturnal supine body position are already present in prediagnostic PD, independently of RBD status. Prospective longitudinal studies are necessary to investigate the potential role of these PSG variables as biomarkers for early diagnosis and patient selection in neuroprotective trials,” concluded Dijkstra et al.

Source: Dijkstra F, REM sleep without atonia and nocturnal body position in prediagnostic Parkinson’s disease. Presented at MDS Virtual Congress 2021; Sept 17-22. Virtual.