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Friday, June 30, 2017

Deep Sleep Linked to Slower Parkinson's Progression

Pauline Anderson
June 29, 2017

AMSTERDAM — Patients with Parkinson's disease (PD) who are deep sleepers, defined as getting more slow-wave sleep, have slower progression of their disease compared to light sleepers, new research suggests.
If that's the case, enhancing deep sleep may be a treatment target in PD patients, said Simon Schreiner, MD, Department of Neurology, University of Zurich, Switzerland.
"The association we found between slow-wave sleep and PD progression was very robust," said Dr Schreiner. "It indicates that higher slow-wave sleep predicts a slower progression of axial symptoms as well as gait and postural function in patients with Parkinson's disease."
He presented his study here at the Congress of the European Academy of Neurology (EAN) 2017.
Sleep disturbances are common in PD. It's believed that the underlying neurodegeneration affects the brain system that regulates the sleep-wake cycle, said Dr Schreiner.
However, there's growing evidence of a bidirectional relationship: that sleep disturbances also influence neurodegeneration as well as the other way around, he said.

Very Relevant

"This is very relevant," said Dr Schreiner. "If this is true, this could lead to a vicious cycle resulting in accelerated neurodegeneration due to sleep disturbances. On the other hand, this could offer treatment possibilities aimed at sleep enhancement."
Experts believe that deep sleep (slow-wave sleep) is the most restorative type of sleep. It may have a positive influence on neurodegeneration by promoting clearance of toxins, such as β-amyloid and possibly α-synuclein (a presynaptic neuronal protein linked to PD) from the brain.
Dr Schreiner and his colleagues conducted a retrospective analysis of 131 consecutive patients with PD (mean age, 62.6 years; 34% female), who were seen at their movement disorders outpatient clinic. All the patients had undergone polysomnography.
The mean disease duration of these patients was 5.2 years. The median time between baseline and polysomnography was 3 months.
Researchers collected clinical data at two time points: baseline and a follow-up at least 2 years later. During these examinations, investigators obtained Unified Parkinson's Disease Rating Scale (UPDRS) scores. They also looked at an index of seven UPDRS 3 symptoms (the UPDRS progression factor), which, according to Dr Schreiner, best indicates PD progression. 
These seven symptoms are speech, hypomimia, arise from chair, posture, gait, postural stability, and body bradykinesia.
To quantify deep sleep, investigators used a measure called slow-wave energy (SWE). "This measure represents the depth and duration of slow-wave sleep," said Dr Schreiner.
He noted that the study sample represented "a real-life-scenario cohort" in that the patients were receiving "best medical treatment at each time point."

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