Parkinson's disease (PD) can be divided into motor subtypes: postural instability/gait difficulty (PIGD), tremor dominant, and indeterminate. This study aimed to assess differences in sleep structure and obstructive sleep apnea (OSA) between the PIGD and non-PIGD subtypes. PD participants with or without OSA (defined as apnea-hypopnea index (AHI) ≥ 15 events/hour on overnight polysomnography) were included. Patients were separated into two groups: PIGD and non-PIGD. Linear regression was used to explore differences in sleep, AHI, and other respiratory parameters between groups (adjusted for variables determined a priori). Logistic regression adjusted for the same variables was used to determine if the proportion of patients with OSA differed across groups. Subset analyses were performed: subset 1 excluding patients on psychoactive medication; subset 2 excluding patients taking levodopa or dopaminergic agonists (DAs) at nighttime and subset 3 excluding patients on either of the abovementioned drugs. 146 participants were studied. The non-PIGD group had less N3 sleep compared to the PIGD group (12.4% vs 16.9% p = 0.06), reaching significance in subsets 1 and 3. The AHI was significantly lower in the PIGD group (p = 0.047), including when medication effects were removed (p < 0.05). OSA was more frequent in the non-PIGD group, but only significantly in subset 3 (adjusted OR 0.3, p = 0.04). OSA may be more severe in non-PIGD subtypes, and more frequent, in a subset free of psychoactive medication, and of levodopa and DAs, possibly owing to motor complications and dyskinesia. Future studies are required to confirm this.

中文翻译：

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探索帕金森病运动亚型的阻塞性睡眠呼吸暂停和睡眠结构

帕金森病 (PD) 可分为运动亚型：姿势不稳定/步态困难 (PIGD)、震颤主导型和不确定型。本研究旨在评估 PIGD 和非 PIGD 亚型之间睡眠结构和阻塞性睡眠呼吸暂停 (OSA) 的差异。患有或不患有 OSA 的 PD 参与者（定义为夜间多导睡眠监测中呼吸暂停低通气指数 (AHI) ≥ 15 次/小时）。患者被分为两组：PIGD 组和非 PIGD 组。线性回归用于探索组间睡眠、AHI 和其他呼吸参数的差异（根据先验确定的变量进行调整）。使用针对相同变量进行调整的逻辑回归来确定 OSA 患者的比例在各组之间是否存在差异。进行了子集分析：子集 1 排除了服用精神活性药物的患者；子集 2 不包括夜间服用左旋多巴或多巴胺能激动剂 (DA) 的患者，子集 3 不包括服用上述药物的患者。对 146 名参与者进行了研究。与 PIGD 组相比，非 PIGD 组的 N3 睡眠较少（12.4% vs 16.9% p = 0.06），在子集 1 和 3 中达到显着性。PIGD 组的 AHI 显着较低（p = 0.047），包括当药物效应被消除（p < 0.05）。OSA 在非 PIGD 组中更为常见，但仅在子集 3 中显着（调整后 OR 0.3，p = 0.04）。OSA 在非 PIGD 亚型中可能更严重，在没有精神活性药物、左旋多巴和 DA 的亚型中更常见，可能是由于运动并发症和运动障碍。需要未来的研究来证实这一点。