Sleep movements and associated autonomic nervous activities in patients with Parkinson's disease

Abstract

Nine parkinsonian patients were studied during one night using the static charge sensitive bed (SCSB) method for the monitoring of respiration, ballistocardiogram (BCG) and body movements. The parkinsonian sleep was more restless than that of the controls. As the SCSB-defined levels of autonomic nervous activity were concerned, the amount of motor active wakefulness (MAW) was significantly (P less than 0.05) increased in parkinsonian patients, who also had less quiet sleep (P less than 0.05) than the controls. Parkinsonian tremor was present during 29.8 +/- 15.8% of the time in bed. Usually it was observed during wakefulness; it disappeared when the patient fell asleep. The frequency of turning-over events in bed was smaller in the parkinsonian patients than in the controls (P less than 0.05). When the heart rate changes associated with sleep movements were studied it was found that the parasympathetic deceleration component in the parkinsonian patients was absent. The motor dysfunction associated with Parkinson's disease is reflected in many ways in the sleep movement activity. Sleep disturbances in PD seem to be secondary in character; i.e. they can be due to impaired motor functions like turning around in the bed, or due to impaired arousal mechanisms during sleep.

The Effect of Cabergoline on Sleep, Periodic Leg Movements in Sleep, and Early Morning Motor Function in Patients with Parkinson's Disease

“…This may be interpreted as a reduced sleep state stability of cabergoline and is in line with increased spontaneous awakenings despite greatly reduced PLM in patients with restless legs syndrome undergoing treatment with the dopamine agonist pergolide (Wetter et al, 1999). As nocturnal akinesia is a major problem in patients with PD (Laihinen et al, 1987), an increase in movement time as measured in this study may indicate a treatment-induced restoration of nocturnal mobility. The increase of movement time could therefore be related to sleep improvement despite increased sleep fragmentation.…”

Respiration and Heart Rate Variability during Sleep in Untreated Parkinson Patients

“…The number of awakenings was similar to controls, while other studies [4,28] found more in PD patients. However, in these studies the patients were often receiving /-dopa.…”

Circadian heart rate variability in Parkinson's disease

“…These studies have revealed disturbed HR reactions to sleep movements in PD patients both during non-REM and REM sleep, reflecting combined sympathetic and parasympathetic defects in the cardiovascular regulation [9,16,17,21].Additionally, there is one HR variability study, carried out with a small number of more advanced PD patients on antiparkinsonian medication, that has reported night-time vagal cardiovascular dysfunction [23]. In the present study, the suppression of the HR variability was most pronounced at night, the SD 1 Poincaré component, and the LF and HF spectral components of HR variability differing significantly between the patients and the controls, reflecting dysfunction of the parasympathetic system even in untreated PD patients.…”