Evaluation of consensus sleep stage scoring of dysregulated sleep in Parkinson's disease

Leslie C. West, Michael Summers, Siqun Tang, Lisa Hirt, Casey H. Halpern, Dulce Maroni, Rig Das, Stephen V. Gliske, Aviva Abosch, Clete A. Kushida, John A. Thompson

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective: Sleep dysregulation in Parkinson's disease (PD) has been hypothesized to occur, in part, from dysfunction in the basal ganglia-cortical circuit. Assessment of this relationship requires accurate sleep stage determination, a known challenge in this clinical population. Our objective was to optimize the consensus on the sleep staging process and reduce interrater variability in a cohort of advanced PD subjects. Methods: Fifteen PD subjects were enrolled from three sites in a clinical trial that involved recordings from subthalamic nucleus (STN) deep brain stimulation (DBS) leads (NCT04620551). Video polysomnography (vPSG) data for a total of 45 nights were analyzed. Four experienced scorers independently scored data on initial review. Epochs with less than 75% consensus were flagged for secondary review. In secondary review of discordant epochs, two of the original scorers re-assessed epochs, from which the final consensus stage was derived. Results: Sleep stage classification agreement averaged 83.10% across all sleep stages on initial scoring (IS), and on secondary consensus scoring (CS) review, agreement reached 96.58%. Greatest disagreement was noted in determination of awake epochs (33.6% of discordant epochs) and non-rapid-eye-movement stage 2 (N2) epochs (31.8% of discordant epochs). Scoring discrepancy was resolved with direct measurement of cortical frequency and amplitudes, physiologic context of the epoch, and video review. Conclusion: Our method of multi-level initial and then secondary consensus review scoring resulted in consensus scoring agreement superior to conventional standards. This work features a custom-engineered vPSG software and review platform for integration of consensus sleep stage scoring in a multi-site clinical trial.

Original languageEnglish (US)
Pages (from-to)236-242
Number of pages7
JournalSleep Medicine
Volume107
DOIs
StatePublished - Jul 2023

Keywords

  • Deep brain stimulation
  • Inter-rater agreement
  • Parkinson's disease
  • Sleep stage classification

ASJC Scopus subject areas

  • General Medicine

Fingerprint

Dive into the research topics of 'Evaluation of consensus sleep stage scoring of dysregulated sleep in Parkinson's disease'. Together they form a unique fingerprint.

Cite this