REM and NREM sleep enactment behaviors in Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies

Pietro Luca Ratti, Michele Terzaghi, Brigida Minafra, Alessandra Repetto, Chiara Pasotti, Roberta Zangaglia, Claudio Pacchetti, Raffaele Manni

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background/objective: Nocturnal sleep enactment behaviors (SEBs) are common in patients affected by Parkinson's disease (PD), dementia associated with Parkinson's disease (PDD), and dementia with Lewy bodies (DLB). We investigated the occurrence and neurobiological significance of abnormal SEBs in the context of PD without cognitive decline compared to PDD/DLB patients. Methods: We evaluated a sample of 139 patients with PD, PDD, or DLB in a cross-sectional survey. One hundred and seventeen patients showing either no cognitive impairment (PD group) or meeting the diagnostic requirements for dementia (PDD/DLB group) underwent video-polysomnography. Seventy subjects (42 males) in whom a clear-cut diagnosis of abnormal sleep-related motor-behavioral episodes was possible were included in the final analysis. Results: SEBs consisting of RBD or occurring on arousal from NREM or REM sleep were globally more frequent in the dementia group (PDD/DLB) than in the PD group (p= 0.001), the difference being statistically significant for arousal-related episodes (p= 0.002), while a trend emerged for RBD (p= 0.07). Male sex, daytime sleepiness, higher motor impairment, and lower mini-mental score were significantly more frequent with the occurrence of abnormal sleep-related motor-behavioral episodes. Conclusion: SEBs in PD, PDD, and DLB may consist of RBD episodes or of arousal-related NREM and REM episodes. These latter are more frequent in patients with PDD/DLB and seem to be mainly related to more advanced stages of disease with a higher degree of cognitive decline.

Original languageEnglish
Pages (from-to)926-932
Number of pages7
JournalSleep Medicine
Volume13
Issue number7
DOIs
Publication statusPublished - Aug 2012

Fingerprint

Lewy Body Disease
REM Sleep
Parkinson Disease
Dementia
Sleep
Arousal
Group Processes
Polysomnography
Cross-Sectional Studies

Keywords

  • Arousal disorders
  • Dementia with Lewy bodies
  • NREM parasomnias
  • Parasomnias
  • Parkinson's disease
  • Parkinson's disease dementia
  • REM behavior disorder
  • Sleep enactment

ASJC Scopus subject areas

  • Medicine(all)

Cite this

REM and NREM sleep enactment behaviors in Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies. / Ratti, Pietro Luca; Terzaghi, Michele; Minafra, Brigida; Repetto, Alessandra; Pasotti, Chiara; Zangaglia, Roberta; Pacchetti, Claudio; Manni, Raffaele.

In: Sleep Medicine, Vol. 13, No. 7, 08.2012, p. 926-932.

Research output: Contribution to journalArticle

@article{9c36d23fd1264bb1af5138980db5fd63,
title = "REM and NREM sleep enactment behaviors in Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies",
abstract = "Background/objective: Nocturnal sleep enactment behaviors (SEBs) are common in patients affected by Parkinson's disease (PD), dementia associated with Parkinson's disease (PDD), and dementia with Lewy bodies (DLB). We investigated the occurrence and neurobiological significance of abnormal SEBs in the context of PD without cognitive decline compared to PDD/DLB patients. Methods: We evaluated a sample of 139 patients with PD, PDD, or DLB in a cross-sectional survey. One hundred and seventeen patients showing either no cognitive impairment (PD group) or meeting the diagnostic requirements for dementia (PDD/DLB group) underwent video-polysomnography. Seventy subjects (42 males) in whom a clear-cut diagnosis of abnormal sleep-related motor-behavioral episodes was possible were included in the final analysis. Results: SEBs consisting of RBD or occurring on arousal from NREM or REM sleep were globally more frequent in the dementia group (PDD/DLB) than in the PD group (p= 0.001), the difference being statistically significant for arousal-related episodes (p= 0.002), while a trend emerged for RBD (p= 0.07). Male sex, daytime sleepiness, higher motor impairment, and lower mini-mental score were significantly more frequent with the occurrence of abnormal sleep-related motor-behavioral episodes. Conclusion: SEBs in PD, PDD, and DLB may consist of RBD episodes or of arousal-related NREM and REM episodes. These latter are more frequent in patients with PDD/DLB and seem to be mainly related to more advanced stages of disease with a higher degree of cognitive decline.",
keywords = "Arousal disorders, Dementia with Lewy bodies, NREM parasomnias, Parasomnias, Parkinson's disease, Parkinson's disease dementia, REM behavior disorder, Sleep enactment",
author = "Ratti, {Pietro Luca} and Michele Terzaghi and Brigida Minafra and Alessandra Repetto and Chiara Pasotti and Roberta Zangaglia and Claudio Pacchetti and Raffaele Manni",
year = "2012",
month = "8",
doi = "10.1016/j.sleep.2012.04.015",
language = "English",
volume = "13",
pages = "926--932",
journal = "Sleep Medicine",
issn = "1389-9457",
publisher = "Elsevier",
number = "7",

}

TY - JOUR

T1 - REM and NREM sleep enactment behaviors in Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies

AU - Ratti, Pietro Luca

AU - Terzaghi, Michele

AU - Minafra, Brigida

AU - Repetto, Alessandra

AU - Pasotti, Chiara

AU - Zangaglia, Roberta

AU - Pacchetti, Claudio

AU - Manni, Raffaele

PY - 2012/8

Y1 - 2012/8

N2 - Background/objective: Nocturnal sleep enactment behaviors (SEBs) are common in patients affected by Parkinson's disease (PD), dementia associated with Parkinson's disease (PDD), and dementia with Lewy bodies (DLB). We investigated the occurrence and neurobiological significance of abnormal SEBs in the context of PD without cognitive decline compared to PDD/DLB patients. Methods: We evaluated a sample of 139 patients with PD, PDD, or DLB in a cross-sectional survey. One hundred and seventeen patients showing either no cognitive impairment (PD group) or meeting the diagnostic requirements for dementia (PDD/DLB group) underwent video-polysomnography. Seventy subjects (42 males) in whom a clear-cut diagnosis of abnormal sleep-related motor-behavioral episodes was possible were included in the final analysis. Results: SEBs consisting of RBD or occurring on arousal from NREM or REM sleep were globally more frequent in the dementia group (PDD/DLB) than in the PD group (p= 0.001), the difference being statistically significant for arousal-related episodes (p= 0.002), while a trend emerged for RBD (p= 0.07). Male sex, daytime sleepiness, higher motor impairment, and lower mini-mental score were significantly more frequent with the occurrence of abnormal sleep-related motor-behavioral episodes. Conclusion: SEBs in PD, PDD, and DLB may consist of RBD episodes or of arousal-related NREM and REM episodes. These latter are more frequent in patients with PDD/DLB and seem to be mainly related to more advanced stages of disease with a higher degree of cognitive decline.

AB - Background/objective: Nocturnal sleep enactment behaviors (SEBs) are common in patients affected by Parkinson's disease (PD), dementia associated with Parkinson's disease (PDD), and dementia with Lewy bodies (DLB). We investigated the occurrence and neurobiological significance of abnormal SEBs in the context of PD without cognitive decline compared to PDD/DLB patients. Methods: We evaluated a sample of 139 patients with PD, PDD, or DLB in a cross-sectional survey. One hundred and seventeen patients showing either no cognitive impairment (PD group) or meeting the diagnostic requirements for dementia (PDD/DLB group) underwent video-polysomnography. Seventy subjects (42 males) in whom a clear-cut diagnosis of abnormal sleep-related motor-behavioral episodes was possible were included in the final analysis. Results: SEBs consisting of RBD or occurring on arousal from NREM or REM sleep were globally more frequent in the dementia group (PDD/DLB) than in the PD group (p= 0.001), the difference being statistically significant for arousal-related episodes (p= 0.002), while a trend emerged for RBD (p= 0.07). Male sex, daytime sleepiness, higher motor impairment, and lower mini-mental score were significantly more frequent with the occurrence of abnormal sleep-related motor-behavioral episodes. Conclusion: SEBs in PD, PDD, and DLB may consist of RBD episodes or of arousal-related NREM and REM episodes. These latter are more frequent in patients with PDD/DLB and seem to be mainly related to more advanced stages of disease with a higher degree of cognitive decline.

KW - Arousal disorders

KW - Dementia with Lewy bodies

KW - NREM parasomnias

KW - Parasomnias

KW - Parkinson's disease

KW - Parkinson's disease dementia

KW - REM behavior disorder

KW - Sleep enactment

UR - http://www.scopus.com/inward/record.url?scp=84863865972&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863865972&partnerID=8YFLogxK

U2 - 10.1016/j.sleep.2012.04.015

DO - 10.1016/j.sleep.2012.04.015

M3 - Article

VL - 13

SP - 926

EP - 932

JO - Sleep Medicine

JF - Sleep Medicine

SN - 1389-9457

IS - 7

ER -