POLYSOMNOGRAPHIC SLEEP MEASURES IN PARKINSONS-DISEASE PATIENTS WITH TREATMENT-INDUCED HALLUCINATIONS

Prior studies of sleep in Parkinson's disease (PD) have been compromis ed by inadequate comparison groups, mixed medication regimens, and abs ence of quantitative data collection. This is the first study to compa re polysomnographic sleep measures in PD patients on only dopaminergic medications with and without hallucinations. We performed two consecu tive nights of polysomnography in 10 nondepressed, nondemented PD pati ents, 5 with and 5 without hallucinations. All patients were being tre ated with carbidopa/levodopa and a dopaminergic agonist only. Hallucin ators and nonhallucinators were group-matched for age, PD duration, se verity, and medication doses. Both groups had abnormal sleep records. In particular, there was a reduction in K-complexes and spindle format ion, and the frequent occurrence of motor activation during rapid eye movement (REM) sleep consistent with REM behavior disorder. The halluc inator group had a significantly lower sleep efficiency (0.25 in hallu cinators vs 0.61 in nonhallucinators, p = 0.006), a reduced total REM sleep time (mean total REM sleep time, 3 minutes in hallucinators vs 5 0 in nonhallucinators; p = 0.005), and a reduced REM percentage (mean, 5% in hallucinators vs 20% in nonhallucinators; p = 0.011). This stud y demonstrates that advanced PD patients treated with dopaminergic age nts have abnormal sleep patterns and that those with dopaminergic-indu ced hallucinations have significantly greater REM aberrations than non hallucinating PD patients.