title: Sleep stability and transitions in patients with idiopathic REM sleep behavior disorder and patients with Parkinson's disease.
abstract: OBJECTIVE
  Patients with idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) are at high risk of developing Parkinson's disease (PD). As wake/sleep-regulation is thought to involve neurons located in the brainstem and hypothalamic areas, we hypothesize that the neurodegeneration in iRBD/PD is likely to affect wake/sleep and REM/non-REM (NREM) sleep transitions.
  
  
  METHODS
  We determined the frequency of wake/sleep and REM/NREM sleep transitions and the stability of wake (W), REM and NREM sleep as measured by polysomnography (PSG) in 27 patients with PD, 23 patients with iRBD, 25 patients with periodic leg movement disorder (PLMD) and 23 controls. Measures were computed based on manual scorings and data-driven labeled sleep staging.
  
  
  RESULTS
  Patients with PD showed significantly lower REM stability than controls and patients with PLMD. Patients with iRBD had significantly lower REM stability compared with controls. Patients with PD and RBD showed significantly lower NREM stability and significantly more REM/NREM transitions than controls.
  
  
  CONCLUSIONS
  We conclude that W, NREM and REM stability and transitions are progressively affected in iRBD and PD, probably reflecting the successive involvement of brain stem areas from early on in the disease.
  
  
  CONCLUSIONS
  Sleep stability and transitions determined by a data-driven approach could support the evaluation of iRBD and PD patients.
authors.affiliation: Department of Electrical Engineering, Technical University of Denmark, Kongens Lyngby, Denmark; Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark; H. Lundbeck A/S, Copenhagen, Denmark. Electronic address: julie.a.e.christensen@gmail.com.
authors.forename: Julie Anja Engelhard
authors.initials: JAE
authors.lastname: Christensen
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark.
authors.forename: Poul
authors.initials: P
authors.lastname: Jennum
authors.affiliation: Department of Electrical Engineering, Technical University of Denmark, Kongens Lyngby, Denmark.
authors.forename: Henriette
authors.initials: H
authors.lastname: Koch
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark.
authors.forename: Rune
authors.initials: R
authors.lastname: Frandsen
authors.affiliation: Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark; Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark.
authors.forename: Marielle
authors.initials: M
authors.lastname: Zoetmulder
authors.affiliation: H. Lundbeck A/S, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Arvastson
authors.affiliation: H. Lundbeck A/S, Copenhagen, Denmark.
authors.forename: Søren Rahn
authors.initials: SR
authors.lastname: Christensen
authors.affiliation: Department of Electrical Engineering, Technical University of Denmark, Kongens Lyngby, Denmark.
authors.forename: Helge Bjarrup Dissing
authors.initials: HBD
authors.lastname: Sorensen
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D017286:Polysomnography / Q000379:methods; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology*
keywords: Data-driven detection; Parkinson’s disease; Polysomnography; Rapid eye movement sleep behavior disorder; Sleep transitions