P025 Atypical N3 Sleep: A Biomarker for Altered Mental Status in Lewy Body Disease?

Abstract Introduction Atypical N3 sleep (AN3=delta waves with limited theta and sigma) has been associated with ICU delirium and sepsis and averaged 25% of sleep time in Japanese ICU patients. We were interested in exploring whether AN3 might be a marker of cerebral dysfunction in ambulatory patients across a range of neurodegenerative disorders, including those with a dementia diagnosis. Methods After ethics review and with informed consent, patients with Lewy body disease (DLB/PDD: n=20,male=90%,age=70 + 6.2), Alzheimers disease dementia (AD: n=29,male=79%,age=75 + 6.7), Parkinson disease (PD: n=16,male=69%,age=67 + 8.7), mild cognitive impairment (MCI: n=41,male=63%,age=70 + 8.5), isolated REM sleep behavior disorder (iRBD: n=19,male=74%,age=64 + 9.6) and a control group (CG: n=61,male=47%,age=65 + 8.3) were studied with the Sleep Profiler and auto-detected AN3 computed. Between-group comparisons were assessed with Mann-Whitney U and Chi-square tests. Results The mean percentages of sleep time with AN3 were significantly greater in DLB/PDD (8 + 12.3) vs. PD (4 + 10.8), AD (2 + 3.7), MCI (2 + 2.3), iRBD (1 + 1.6), and CG (1 + 2.4)(all p<0.02). The proportions of records with abnormal AN3 (>5% of sleep time) were significantly greater in those with DLB/PDD=35% vs. MCI=10%, iRBD=5% and CG=5% (all p<0.05), but not AD=17% and PD=13%. Conclusions Further investigations are needed to determine if abnormal AN3 may be a biomarker that distinguishes patients with Lewy body spectrum diseases from alternative pathologies and/or could be helpful in monitoring the side effects of CNS-acting medications