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Pallido-Ponto-Nigral Degeneration Affects Sleep

May experience reductions in total sleep time, sleep efficiency, prolonged initial sleep latency

WEDNESDAY, June 29 (HealthDay News) -- Patients with pallido-ponto-nigral degeneration (PPND) have severe sleep dysfunction and reductions in total sleep time and efficiency, according to a study published in the June issue the of Annals of Neurology.

Andrew R. Spector, M.D., from the Mayo Clinic in Jacksonville, Fla., and colleagues examined the nature of sleep disturbance in PPND and compared these results to those in other progressive neurological illnesses. Five affected and five unaffected individuals were recruited from the PPND kindred and underwent clinical assessment, polysomnography, and wrist actigraphy. In affected individuals, postmortem analysis of available sleep-relevant areas was carried out.

The investigators found that the average total sleep time was 130.8 minutes for the affected group and 403.6 minutes for the control group. Affected individuals had significantly longer initial sleep latency (58 to 260 minutes versus 3 to 34 minutes), an increase in stage I sleep (8.5 versus 1 percent), and less stage III/IV sleep (8.5 versus 17 percent) compared to controls. Autopsy showed that all affected individuals had severe neuronal tau pathology in wake-promoting nuclei and reductions in thalamic cholinergic innervations. Compared to controls, no difference was seen in orexinergic fiber density in nucleus basalis of Meynert or locus ceruleus in affected individuals.

"Significant reductions in total sleep time, sleep efficiency, and in stage I, III, and IV sleep, along with prolonged initial sleep latency, were observed. There was also a trend toward a lower REM sleep percentage," the authors write.

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