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Sleep and circadian rhythm regulation in early Parkinson disease

Breen, David P ; Vuono, Romina ; Nawarathna, Upekshani ; Fisher, Kate ; Shneerson, John M ; Reddy, Akhilesh B and Barker, Roger A LU (2014) In JAMA Neurology 71(5). p.95-589
Abstract

IMPORTANCE: Sleep disturbances are recognized as a common nonmotor complaint in Parkinson disease but their etiology is poorly understood.

OBJECTIVE: To define the sleep and circadian phenotype of patients with early-stage Parkinson disease.

DESIGN, SETTING, AND PARTICIPANTS: Initial assessment of sleep characteristics in a large population-representative incident Parkinson disease cohort (N=239) at the University of Cambridge, England, followed by further comprehensive case-control sleep assessments in a subgroup of these patients (n=30) and matched controls (n=15).

MAIN OUTCOMES AND MEASURES: Sleep diagnoses and sleep architecture based on polysomnography studies, actigraphy assessment, and 24-hour analyses of serum... (More)

IMPORTANCE: Sleep disturbances are recognized as a common nonmotor complaint in Parkinson disease but their etiology is poorly understood.

OBJECTIVE: To define the sleep and circadian phenotype of patients with early-stage Parkinson disease.

DESIGN, SETTING, AND PARTICIPANTS: Initial assessment of sleep characteristics in a large population-representative incident Parkinson disease cohort (N=239) at the University of Cambridge, England, followed by further comprehensive case-control sleep assessments in a subgroup of these patients (n=30) and matched controls (n=15).

MAIN OUTCOMES AND MEASURES: Sleep diagnoses and sleep architecture based on polysomnography studies, actigraphy assessment, and 24-hour analyses of serum cortisol, melatonin, and peripheral clock gene expression (Bmal1, Per2, and Rev-Erbα).

RESULTS: Subjective sleep complaints were present in almost half of newly diagnosed patients and correlated significantly with poorer quality of life. Patients with Parkinson disease exhibited increased sleep latency (P = .04), reduced sleep efficiency (P = .008), and reduced rapid eye movement sleep (P = .02). In addition, there was a sustained elevation of serum cortisol levels, reduced circulating melatonin levels, and altered Bmal1 expression in patients with Parkinson disease compared with controls.

CONCLUSIONS AND RELEVANCE: Sleep dysfunction seen in early Parkinson disease may reflect a more fundamental pathology in the molecular clock underlying circadian rhythms.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
keywords
Aged, Case-Control Studies, Circadian Rhythm, Cohort Studies, Early Diagnosis, Female, Humans, Male, Middle Aged, Parkinson Disease, Sleep, Sleep Disorders, Circadian Rhythm, Journal Article, Research Support, Non-U.S. Gov't
in
JAMA Neurology
volume
71
issue
5
pages
7 pages
publisher
American Medical Association
external identifiers
  • pmid:24687146
  • scopus:84900478730
ISSN
2168-6157
DOI
10.1001/jamaneurol.2014.65
language
English
LU publication?
no
id
8e3e35d5-a3ee-468f-ab0e-a5be54e8fac6
date added to LUP
2016-11-24 15:10:00
date last changed
2022-05-10 02:38:34
@article{8e3e35d5-a3ee-468f-ab0e-a5be54e8fac6,
  abstract     = {{<p>IMPORTANCE: Sleep disturbances are recognized as a common nonmotor complaint in Parkinson disease but their etiology is poorly understood.</p><p>OBJECTIVE: To define the sleep and circadian phenotype of patients with early-stage Parkinson disease.</p><p>DESIGN, SETTING, AND PARTICIPANTS: Initial assessment of sleep characteristics in a large population-representative incident Parkinson disease cohort (N=239) at the University of Cambridge, England, followed by further comprehensive case-control sleep assessments in a subgroup of these patients (n=30) and matched controls (n=15).</p><p>MAIN OUTCOMES AND MEASURES: Sleep diagnoses and sleep architecture based on polysomnography studies, actigraphy assessment, and 24-hour analyses of serum cortisol, melatonin, and peripheral clock gene expression (Bmal1, Per2, and Rev-Erbα).</p><p>RESULTS: Subjective sleep complaints were present in almost half of newly diagnosed patients and correlated significantly with poorer quality of life. Patients with Parkinson disease exhibited increased sleep latency (P = .04), reduced sleep efficiency (P = .008), and reduced rapid eye movement sleep (P = .02). In addition, there was a sustained elevation of serum cortisol levels, reduced circulating melatonin levels, and altered Bmal1 expression in patients with Parkinson disease compared with controls.</p><p>CONCLUSIONS AND RELEVANCE: Sleep dysfunction seen in early Parkinson disease may reflect a more fundamental pathology in the molecular clock underlying circadian rhythms.</p>}},
  author       = {{Breen, David P and Vuono, Romina and Nawarathna, Upekshani and Fisher, Kate and Shneerson, John M and Reddy, Akhilesh B and Barker, Roger A}},
  issn         = {{2168-6157}},
  keywords     = {{Aged; Case-Control Studies; Circadian Rhythm; Cohort Studies; Early Diagnosis; Female; Humans; Male; Middle Aged; Parkinson Disease; Sleep; Sleep Disorders, Circadian Rhythm; Journal Article; Research Support, Non-U.S. Gov't}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{95--589}},
  publisher    = {{American Medical Association}},
  series       = {{JAMA Neurology}},
  title        = {{Sleep and circadian rhythm regulation in early Parkinson disease}},
  url          = {{http://dx.doi.org/10.1001/jamaneurol.2014.65}},
  doi          = {{10.1001/jamaneurol.2014.65}},
  volume       = {{71}},
  year         = {{2014}},
}