Advanced

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.

(Less)
Please use this url to cite or link to this publication:
author
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
  • 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
2017-11-19 04:35:12
@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},
  keyword      = {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},
  volume       = {71},
  year         = {2014},
}