Sleep Disorders as Potential Early Signs of Neurodegenerative Diseases

Recent research highlights the significance of sleep disorders, particularly REM Sleep Behavior Disorder (RBD), as early indicators of neurodegenerative conditions like Parkinson's disease and Lewy body dementia (LBD). Conducted at the Center for Advanced Research in Sleep Medicine (CARSM) at Montreal's Sacré-Coeur Hospital, the studies involve patients who exhibit abnormal behaviors during REM sleep, such as punching, kicking, and screaming—which are deviations from the typical muscle paralysis seen during dreaming. Unlike sleepwalking, which occurs during slow-wave sleep, RBD manifests during REM sleep and usually affects individuals around middle age.

While factors like antidepressant use and sleep apnea can contribute to RBD, its presence is particularly concerning due to its strong association with the development of Parkinsonian syndromes and LBD. Nearly 90% of individuals diagnosed with RBD eventually develop these neurodegenerative diseases. Experts are actively investigating the brain atrophy patterns linked to RBD to understand disease progression better, with preliminary findings being published in eBioMedicine.

Through advanced imaging and machine learning, researchers have identified two distinct patterns of brain deterioration: one starting in the cortex and spreading inward, associated with LBD, and another beginning inward and progressing outward, common in Parkinson's disease. These insights aim to facilitate early detection and personalized treatment strategies by enabling clinicians to identify disease stages from MRI scans more objectively than traditional assessments.

The overarching goal is to discover reliable biomarkers that can predict disease progression, allowing for timely interventions. This research underscores the importance of sleep disorder screenings in at-risk populations as a potential window for early diagnosis of neurodegenerative diseases, ultimately advancing efforts to develop more effective treatments.