Circadian Rhythms of Sleep–Wake, Thermoregulatory and Cardiovascular Function in Progressive Supranuclear Palsy

Background: The sleep–wake cycle and the autonomic nervous system (ANS) can be impaired in neurodegenerative diseases. Objectives: To describe sleep–wake cycle and circadian rhythms of body core temperature (BcT) and cardiovascular parameters in Progressive Supranuclear Palsy (PSP). Methods: We prospectively recorded 48 hour video-polysomnography, BcT and blood pressure (BP) in 14 PSP patients (disease duration 5.9 ± 2.6 years) under controlled environmental conditions. We analyzed wake–sleep parameters and state-dependent modulation for BcT, BP and heart rate from the last 24 h of recording. Twelve healthy younger controls were used for comparison. Results: Patients slept less than 5 hours/night with frequent awakenings, daytime naps were shorter than 60 minutes and mainly represented by light sleep resulting in a 24 h sleep deprivation. Patients with PSP slept less compared to younger controls and normative values for age. Only two patients reported excessive daytime sleepiness. There were no significant differences in sleep parameters according to the presence of sleep disorders. Compared to controls, patients showed significantly higher BcT values during wake and sleep. Twelve patients presented an abnormal BP pattern at nighttime. Conclusion: PSP patients experienced profound sleep deprivation across the 24 h study period. An imbalance between sympathetic and parasympathetic function with sympathetic predominance may be associated with this alteration. Whether this autonomic dysfunction is the primary drive for the sleep–wake cycle disruption or the consequence of sleep loss needs to be elucidated.