Imagine your body is a clock with many intricate gears. Now, picture this: when some of these gears malfunction, they not only disrupt the clock’s ticking but also affect another mechanism nearby. Similarly, in Parkinson’s disease (PD), non-motor symptoms like sleep disorders and depression go hand in hand. A recent study delved into the impact of sleep disorders on depressive symptoms in individuals with early and prodromal PD. The researchers found that specific sleep disorders, such as probable rapid eye movement (REM) sleep behavior disorder (pRBD) and daytime sleepiness, were associated with higher levels of depression-related symptoms. This relationship persisted over a span of five years. Fascinatingly, the study also revealed that an increase in daytime sleepiness was linked to a higher degree of depressive symptoms. Moreover, autonomic dysfunction was found to partially mediate the connection between REM sleep behavior disorder and depression in PD patients. These findings underscore the importance of sleep management for monitoring disease progression in Parkinson’s patients. Want to learn more? Dive into the full research article!

BackgroundNon-motor symptoms, including sleep disorders and depression, are common in Parkinson’s disease (PD). The purpose of our study is to explore the effect of sleep disorders, including the probable rapid eye movement (REM) sleep behavior disorder (pRBD) and the daytime sleepiness, on depressive symptoms in patients with early and prodromal PD.MethodsA total of 683 participants who obtained from the Parkinson Progression Markers Initiative (PPMI) were included, consisting of 423 individuals with early PD, 64 individuals with prodromal PD, and 196 healthy controls (HCs), who were followed up to 5 years from baseline. Multiple linear regression models and linear mixed-effects models were conducted to explore the relationship between sleep disorders and depression at baseline and longitudinally, respectively. Multiple linear regression models were used to further investigate the association between the change rates of daytime sleepiness score and depression-related score. Mediation analyses were also performed.ResultsAt baseline analysis, individuals with early and prodromal PD, who had higher RBD screening questionnaire (RBDSQ) score, or who were considered as pRBD, or who manifested specific behaviors of RBD (things falling down when sleep or disturbance of sleep), showed significantly the higher score of depression-related questionnaires. Our 5-year follow-up study showed that sleep disorders, including pRBD and daytime sleepiness, were associated with the increased depressive-related score in individuals with early and prodromal PD. Interestingly, we also found that the increased possibilities of daytime sleepiness were associated with depressive-related score. Finally, mediation analysis demonstrated that the relationship between RBD and depressive symptoms was partially mediated by autonomic symptoms, such as postural hypertension, salivation, dysphagia, and constipation.ConclusionOur study shows that sleep disorders, including pRBD and daytime sleepiness, are associated with depression at baseline and longitudinally, which is partially mediated by the autonomic dysfunction in early and prodromal PD, with an implication that sleep management is of great value for disease surveillance.

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