Characterization of Sleep Structure and Autonomic Dysfunction in REM Sleep Behavior Disorder

Goal: REM Sleep Behavior Disorder (RBD) is a REM parasomnia that is associated to high risk of developing α-synucleinopathies, as Parkinson's disease (PD) or dementia with Lewy bodies, over time. This study aims at investigating the presence of autonomic dysfunctions in RBD subjects, with and w...

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Published in:IEEE open journal of engineering in medicine and biology 2024-01, Vol.5, p.859-866
Main Authors: Mandas, Nicla, Mollura, Maximiliano, Baldazzi, Giulia, Sattar, Parisa, Mura, Maria, Casaglia, Elisa, Figorilli, Michela, Giorgetti, Laura, Mattioli, Pietro, Calizzano, Francesco, Fama, Francesco, Arnaldi, Dario, Puligheddu, Monica, Pani, Danilo, Barbieri, Riccardo
Format: Article
Language:English
Subjects:
Autonomous nervous system
Behavior disorders
Coexistence
Dementia disorders
Diseases
Dynamic structural analysis
Dysautonomia
Heart rate
Heart rate variability
heart rate variability (HRV)
Indexes
Lewy bodies
Markov chains
Movement disorders
Nervous system
Neurodegenerative diseases
Parkinson's disease
point process
Rapid eye movement sleep
REM sleep
REM sleep behavior disorder
Sleep
Sleep disorders
Sociology
Statistical models
Statistics
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Summary:Goal: REM Sleep Behavior Disorder (RBD) is a REM parasomnia that is associated to high risk of developing α-synucleinopathies, as Parkinson's disease (PD) or dementia with Lewy bodies, over time. This study aims at investigating the presence of autonomic dysfunctions in RBD subjects, with and without PD, by assessing their sleep structure and autonomous nervous system activity along the different sleep stages. Methods: To this aim, an innovative framework combining a sleep transition model, by Markov chains, with an instantaneous assessment of autonomic state dynamics by statistical modeling of heart rate variability (HRV) dynamics through a point-process approach, was introduced. Results: In general, RBD groups showed lower HRV than controls across all sleep stages, as well as higher probabilities of transitioning towards lighter sleep stages. Subjects also affected by PD present an even lower HRV, but better sleep continuity. Conclusions: RBD patients suffer from sleep fragmentation and overall autonomic dysfunction, mainly due to lower autonomic activation across all sleep stages. Coexistence of PD seems to improve sleep quality, possibly due to a sleep-related relief of their symptoms.
ISSN:2644-1276
2644-1276
DOI:10.1109/OJEMB.2024.3397550