1146 Are Motor Symptoms Occurring During Sleep an Early Predictor of Parkinson’s Disease?

Abstract Introduction Parkinson’s disease (PD) is a progressive neurodegenerative disorder which may cause sleep disturbances and sleep-related motor dysregulation. This study examined sleep characteristics and sleep-related motor symptoms associated with PD and PD incidence in the general population. Methods A representative sample of non-institutionalized U.S. adults aged ≥18 years was interviewed in two waves between 2002 and 2015 using the Sleep-EVAL system, an AI-driven diagnostic platform aligned with DSM-IV-TR and ICSD-II criteria. Wave 1 included 15,929 participants, of whom 10,931 were interviewed again approximately three years later. PD diagnosis required physician confirmation. Weighted prevalence estimates, bivariate analyses, and multivariate logistic regression models adjusted for age, gender, race, and antidepressant use were used to identify sleep-related predictors of incident PD. Results PD prevalence at baseline was 0.48%, with the highest prevalence among adults ≥75 years. At follow-up, the prevalence was 0.71%, also increasing with age. The incidence was 0.078% per year (95% CI: 0.026–0.131%); 87% of incident cases were male. Compared to those without PD, participants with PD showed higher rates of automatic behaviors (12.0% vs. 5.3%; p< 0.001), moderate to severe daytime sleepiness (35.5% vs. 25.1% combined), sleep talking (17.1% vs. 3.3%; p< 0.001), excessive limb movements during sleep (32.9% vs. 16.3%; p< 0.001), and leg jerks at sleep onset (21.1% vs. 5.1%; p< 0.001). Muscle weakness symptoms were higher in PD: 47.9% reported ≥1 symptom vs. 21.3% in non-PD participants (p< 0.001). Multivariate models identified several predictive sleep symptoms for incident PD: teeth grinding nearly every night (AOR=3.78), excessive limb movements during sleep (AOR≈2.58), and leg jerks at sleep onset (AOR=9.54–15.64 across models) significantly increased PD risk, independent of age, gender, race and antidepressant use. Conclusion PD in the general population is strongly associated with multiple sleep disturbances and nocturnal motor symptoms. Teeth grinding, excessive limb movements, and leg jerks at sleep onset emerged as independent predictors of incident PD. These results suggest that sleep-related motor dysregulation may precede the clinical diagnosis. These findings underscore the potential value of sleep assessments in identifying individuals at risk for PD. Support (if any) Investigator-initiated study - UCB Biopharma SRL