Deep Brain Stimulation Alters Sleep Physiology and Architecture in Parkinson’s Disease: A Prospective, Multi-Night, Naturalistic Polysomnography Study

Sleep disturbances are among the most common non-motor Parkinson’s disease (PD) symptoms. Deep brain stimulation (DBS) may improve sleep, though methodological inconsistencies in prior studies have produced inconsistent results. We sought to investigate the effect of DBS on sleep, including both sleep architecture and physiological features such as sleep spindles and slow waves. We prospectively enrolled PD patients undergoing DBS surgery and performed in-home sleep monitoring over multiple nights both pre-operatively and post-operatively. After DBS implantation, improvements were seen in several parameters, including both subjective measures (Parkinson Disease Sleep Scale, version 2) and objective measures (total sleep time, N2 duration, N3 duration, and sleep efficiency). Slow wave density and duration, as well as sleep spindle frequency and amplitude, were affected by DBS. This study provides the most comprehensive evaluation of the effect of DBS on sleep in PD, and the first to prospectively study the effect of DBS on sleep physiological features, including slow waves and sleep spindles.