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Cited by 139Circadian rhythm and melatoninParkinson's Disease Mechanisms and TreatmentsSleep and related disorders

Disturbances in melatonin secretion and circadian sleep-wake regulation in Parkinson disease

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Bolitho, S.J., Naismith, S.L., Rajaratnam, S.M.W., Grunstein, R.R., Hodges, J.R., Terpening, Z., Rogers, N., Lewis, S.J.G.·2014·Sleep Medicine
DOI 10.1016/j.sleep.2013.10.016
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Abstract

Objective Using salivary dim light melatonin onset (DLMO) and actigraphy, our study sought to determine if Parkinson disease (PD) patients demonstrate circadian disturbance compared to healthy controls. Additionally, our study investigated if circadian disturbances represent a disease-related process or may be attributed to dopaminergic therapy.Methods Twenty-nine patients with PD were divided into unmedicated and medicated groups and were compared to 27 healthy controls. All participants underwent neurologic assessment and 14 days of actigraphy to establish habitual sleep-onset time (HSO). DLMO time and area under the melatonin curve (AUC) were calculated from salivary melatonin sampling. The phase angle of entrainment was calculated by subtracting DLMO from HSO. Overnight polysomnography (PSG) was performed to determine sleep architecture.Results DLMO and HSO were not different across the groups. However, the phase angle of entrainment was more than twice as long in the medicated PD group compared to the unmedicated PD group (U = 35.5; P = .002) and was more than 50% longer than controls (U = 130.0; P = .021). The medicated PD group showed more than double the melatonin AUC compared to the unmedicated group (U = 31; P = 0.001) and controls (U = 87; P = .001). There was no difference in these measures comparing unmedicated PD and controls.Conclusions In PD dopaminergic treatment profoundly increases the secretion of melatonin. Our study reported no difference in circadian phase and HSO between groups. However, PD patients treated with dopaminergic therapy unexpectedly showed a delayed sleep onset relative to DLMO, suggesting dopaminergic therapy in PD results in an uncoupling of circadian and sleep regulation.

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  • Bolitho et al. demonstrated prolongation of the phase angle of entrainment of melatonin rhythm in medicated Parkinson's disease patients compared to the PD un-medicated group and controls.

    “Bolitho et al. demonstrated prolongation of the phase angle of entrainment of melatonin rhythm in the medicated PD patients compared to the PD un-medicated group and controls (Bolitho et al., 2014).”

    From Circadian dysregulation in Parkinson's disease (2017) · cites this paper as Bolitho et al., 2014

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Authors
Bolitho, S. J., Naismith, S. L., Rajaratnam, S. M. W., Grunstein, R. R., Hodges, J. R., Terpening, Z., Rogers, N., & Lewis, S. J. G.
Affiliations
  • The University of Sydney (AU)
  • Monash University (AU)
  • Neuroscience Research Australia (AU)
  • Central Queensland University (AU)
Corresponding author
Lewis, S.J.G.
ORCID
Venue
Sleep Medicine
Publisher
Elsevier BV
Published
2014-03
Volume
15
Issue
3
Pages
342-347
ISSN
1389-9457 (ISSN-L)
DOI
10.1016/j.sleep.2013.10.016
OpenAlex
W2004649075
Cited by
139
References
41
Citations by year
2026: 5 · 2025: 13 · 2024: 8 · 2023: 14 · 2022: 10 · 2021: 17 · 2020: 15 · 2019: 8 · 2018: 8 · 2017: 11 · 2016: 17 · 2015: 6 · 2014: 7
FWCI
6.66
Type
journal article
Language
en
Open access
Licence
Locations
  • Sleep Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Acquire (CQUniversity) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
International Parkinson and Movement Disorder Society
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
Parkinson's disease, melatonin secretion, circadian rhythm, sleep-wake regulation, dopaminergic therapy, dim light melatonin onset, actigraphy, sleep architecture, salivary melatonin
MeSH terms
Antiparkinson Agents, Female, Humans, Levodopa, Male, Melatonin, Middle Aged, Parkinson Disease, Saliva, Case-Control Studies, Polysomnography, Chronobiology Disorders, Actigraphy

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