Sleep stage mixing is associated with poor prognosis in early Parkinson’s disease
This study assessed the prognostic value of probabilistic sleep staging in early PD by quantifying sleep stage uncertainty and mixing. Data from two longitudinal cohorts (DeNoPa and ICEBERG) included 280 patients with early PD (mean duration 21.1 months) and 158 matched controls. Sleep stages were scored automatically using U-Sleep, which provides for each 30-s epoch a probabilistic distribution of wakefulness (W), NREM stage N1, N2, N3, and REM sleep. Uncertainty (percentage of sleep stages with less than 80% certainty) and mixed stages were quantified. PD patients showed higher sleep stage uncertainty and wake-N3 mixing, especially those with REM sleep behavior disorder. Greater W-N3 mixing was associated with worse motor and cognitive scores at baseline and with faster motor decline over time. EEG features of this mixing suggested unstable deep sleep. These findings support the value of automated sleep analysis to detect microstructural sleep disruptions linked to PD progression.
Authors
- Claudia Trenkwalder (ORCID: https://orcid.org/0000-0001-6407-1199)
- Stéphane Lehéricy (ORCID: https://orcid.org/0000-0002-5802-3518)
- Pauline Dodet (ORCID: https://orcid.org/0000-0002-7078-8345)
- Smaranda Leu‐Semenescu (ORCID: https://orcid.org/0000-0001-9556-4527)
- Andreas Brink-Kjær (ORCID: https://orcid.org/0000-0002-2872-0929)
- Poul Jennum (ORCID: https://orcid.org/0000-0001-6986-5254)
- Emmanuel During (ORCID: https://orcid.org/0000-0002-0539-5115)
- Isabelle Arnulf (ORCID: https://orcid.org/0000-0002-2240-2516)
- Thomas Andrillon (ORCID: https://orcid.org/0000-0003-2794-8494)
- Emmanuel Mignot (ORCID: https://orcid.org/0000-0002-6928-5310)
- Brit Mollenhauer (ORCID: https://orcid.org/0000-0001-8437-3645)
- Friederike Sixel‐Döring (ORCID: https://orcid.org/0000-0002-7967-6286)
- Graziella Mangone
- Emmanuel Roze
- Marie Vidailhet
- Jean-Christophe Corvol
Institutions
- Centre National de la Recherche Scientifique (FR)
- Inserm (FR)
- Glostrup Hospital (DK)
- Sorbonne Université (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Pitié-Salpêtrière Hospital (FR)
- Paracelsus Elena Klinik Kassel (DE)
- Institut de Psychiatrie et Neurosciences de Paris (FR)
- Stanford Medicine (US)
- Technical University of Denmark (DK)
- Stanford University (US)
- Icahn School of Medicine at Mount Sinai (US)
Publication Details
- Journal
- npj Parkinson s Disease
- Published
- 2025-09-26
- DOI
- https://doi.org/10.1038/s41531-025-01105-w
- Primary Topic
- Sleep and Wakefulness Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Michael J. Fox Foundation for Parkinson's Research
- Sanofi
- Biogen
- Teva Pharmaceutical Industries
- EU Joint Programme – Neurodegenerative Disease Research
- Philippe Foundation
- Amadys
- Fondation Desmarest
- Agence Nationale de la Recherche
- Institut National de la Santé et de la Recherche Médicale
- Association France Parkinson
- EVER Neuro Pharma
- Servier
- Fondation EDF
- Ipsen
- Deutsche Parkinson Vereinigung
- Idorsia Pharmaceuticals
- Direction de l’hospitalisation et de l’offre de Soins