Dynamic sleep stage transition process analysis in patients with Parkinson's disease having sleep apnea syndrome

Abstract

Early detection of non-motor symptoms, such as sleep disorder, is recommended for those with Parkinson's disease (PD). It is important to understand the sleep patterns of patients with PD having concomitant sleep apnea syndrome (SAS). The effect of PD on static sleep variables has been investigated, but its effect on the dynamic transition process of sleep stage has not been fully clarified. The aim of this study was to analyze the dynamic transition process of sleep stages between patients with PD with concomitant SAS and non-PD patients with SAS and to clarify one aspect of the difference in sleep disorder pathology in both patient groups. Sleep stage data of 31 patients with PD and concomitant SAS and 31 propensity score matched non-PD patients with SAS were analyzed, and (i) normalized transition probability and transition rate between each sleep stage as well as (ii) cumulative probability density function of the duration of each sleep stage were calculated. It was found that normalized transition probability and transition rate from rapid eye movement (REM) to Wake and from Wake to REM in PD patients with concomitant SAS were significantly lower than those in the non-PD patients with SAS. In addition, the cumulative probability density function of the duration of sleep stages was compared, and Wake and REM of PD patients with concomitant SAS were significantly more likely to continue than those of the non-PD patients with SAS. These results suggest that both REM-to-Wake transition and Wake-to-REM transition are less likely to occur in PD patients with SAS and that the stage is more likely to continue once Wake and REM sleep occur.

Keywords

• Sleep stage
• Parkinson's disease
• Sleep apnea
• Transition probability
• Rapid eye movement (REM)