Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Exploring the link between subjective sleep quality and nocturnal cardiac autonomic function in Parkinson's disease: A cross-sectional study using 24-hour ambulatory electrocardiography.
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Liu Yonghong, Wang Ping, Wang Ruidan, Fang Jinping, Liu Yanjun, Su Yuan, Wang Yixuan, Liu Aixian, Fang Boyan
Аннотация
BACKGROUND: Sleep complaints and autonomic dysfunction are common non-motor manifestations of Parkinson's disease (PD). We examined the association between subjective sleep quality and nocturnal cardiac autonomic modulation in a retrospective cross-sectional PD cohort.
METHODS: In this retrospective cross-sectional study, we retrospectively analyzed routinely collected standardized clinical assessments and 24-hour ambulatory electrocardiography data from 86 patients with early-to-mid-stage PD. Participants were categorized as having poorer subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI] > 5; n = 56) or better subjective sleep quality (PSQI ≤ 5; n = 30). Natural-log-transformed frequency-domain HRV indices were compared using linear models adjusted for age, sex, Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III, and a PCA-derived composite psychological distress index (CPDI). A complete-case sensitivity analysis among 83 participants with matched Non-Motor Symptoms Scale (NMSS) and REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) data additionally adjusted for disease duration, levodopa equivalent daily dose (LEDD), hypertension, NMSS total product score excluding the sleep/fatigue domain, and RBDSQ score.
RESULTS: In the primary cohort, poorer subjective sleep quality was associated with lower nighttime ln-HF after covariate adjustment (B = -0.546, 95% CI - 0.933 to -0.159; F (1, 80) = 7.897; P = 0.006). No other daytime or nighttime HRV group comparison met the Bonferroni-adjusted threshold. In the complete-case sensitivity analysis, the association remained (B = -0.599, 95% CI -1.028 to -0.170; P = 0.007).
CONCLUSION: Poorer PSQI-defined subjective sleep quality was associated with lower nighttime ln-HF in patients with early-to-mid-stage PD. Prospective longitudinal studies are needed to clarify temporal relationships and clinical relevance.
METHODS: In this retrospective cross-sectional study, we retrospectively analyzed routinely collected standardized clinical assessments and 24-hour ambulatory electrocardiography data from 86 patients with early-to-mid-stage PD. Participants were categorized as having poorer subjective sleep quality (Pittsburgh Sleep Quality Index [PSQI] > 5; n = 56) or better subjective sleep quality (PSQI ≤ 5; n = 30). Natural-log-transformed frequency-domain HRV indices were compared using linear models adjusted for age, sex, Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III, and a PCA-derived composite psychological distress index (CPDI). A complete-case sensitivity analysis among 83 participants with matched Non-Motor Symptoms Scale (NMSS) and REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) data additionally adjusted for disease duration, levodopa equivalent daily dose (LEDD), hypertension, NMSS total product score excluding the sleep/fatigue domain, and RBDSQ score.
RESULTS: In the primary cohort, poorer subjective sleep quality was associated with lower nighttime ln-HF after covariate adjustment (B = -0.546, 95% CI - 0.933 to -0.159; F (1, 80) = 7.897; P = 0.006). No other daytime or nighttime HRV group comparison met the Bonferroni-adjusted threshold. In the complete-case sensitivity analysis, the association remained (B = -0.599, 95% CI -1.028 to -0.170; P = 0.007).
CONCLUSION: Poorer PSQI-defined subjective sleep quality was associated with lower nighttime ln-HF in patients with early-to-mid-stage PD. Prospective longitudinal studies are needed to clarify temporal relationships and clinical relevance.