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Volume 7
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10.3390/neurosci7010006
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Article

Home-Based REM Sleep Without Atonia in Patients with Parkinson’s Disease: A Post Hoc Analysis of the ZEAL Study

by
Hiroshi Kataoka
1,*,
Masahiro Isogawa
2,
Hitoki Nanaura
1,
Hiroyuki Kurakami
2,
Miyoko Hasebe
2,
Kaoru Kinugawa
1,
Takao Kiriyama
1,
Tesseki Izumi
1,
Masato Kasahara
2 and
Kazuma Sugie
1
1
Department of Neurology, Nara Medical University, Kashihara 634-8521, Japan
2
Institute for Clinical and Translational Science, Nara Medical University Hospital, Kashihara 634-8521, Japan
*
Author to whom correspondence should be addressed.
NeuroSci 2026, 7(1), 6; https://doi.org/10.3390/neurosci7010006 (registering DOI)
Submission received: 29 September 2025 / Revised: 21 December 2025 / Accepted: 31 December 2025 / Published: 3 January 2026
(This article belongs to the Special Issue Parkinson's Disease Research: Current Insights and Future Directions)
Review Reports Versions Notes

Abstract

REM sleep behavioral disorder (RBD) is of increasing interest in Parkinson’s disease (PD). Previous studies exploring the association between REM sleep without atonia (RWA) and clinical PD features or other objective sleep metrics are scarce and have used PSG findings. A mobile electroencephalography (EEG)/electrooculography (EOG) recording system with two channels can objectively measure sleep parameters, including RWA, during natural sleep at home. We investigated whether RWA measured on a portable recording device at home could be associated with clinical PD features or other sleep metrics using baseline data from the ZEAL study. Differences between patients with and without RWA was analyzed using ANCOVA test. REM sleep length was significantly longer in patients with RWA than in those without RWA. A multivariate comparison using ANCOVA showed a significant difference in log-transformed REM sleep duration of patients with RWA after adjustment for potential confounders (adjusted mean difference of 1.203; 95% confidence interval 0.468 to 1.937; p = 0.003). The strength of this study was that it evaluated the association between RWA during natural sleep at home and clinical variables as well as other sleep metrics. The major result was that patients with and without RWA did not differ in their clinical variables, and there was no relation between RWA and objective sleep metrics other than REM sleep. The duration of REM sleep may be associated with RWA during natural sleep at home.
Keywords: parkinson; REM; REM sleep without atonia; sleep; REM sleep behavioral disorder; movement disorder parkinson; REM; REM sleep without atonia; sleep; REM sleep behavioral disorder; movement disorder

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MDPI and ACS Style

Kataoka, H.; Isogawa, M.; Nanaura, H.; Kurakami, H.; Hasebe, M.; Kinugawa, K.; Kiriyama, T.; Izumi, T.; Kasahara, M.; Sugie, K. Home-Based REM Sleep Without Atonia in Patients with Parkinson’s Disease: A Post Hoc Analysis of the ZEAL Study. NeuroSci 2026, 7, 6. https://doi.org/10.3390/neurosci7010006

AMA Style

Kataoka H, Isogawa M, Nanaura H, Kurakami H, Hasebe M, Kinugawa K, Kiriyama T, Izumi T, Kasahara M, Sugie K. Home-Based REM Sleep Without Atonia in Patients with Parkinson’s Disease: A Post Hoc Analysis of the ZEAL Study. NeuroSci. 2026; 7(1):6. https://doi.org/10.3390/neurosci7010006

Chicago/Turabian Style

Kataoka, Hiroshi, Masahiro Isogawa, Hitoki Nanaura, Hiroyuki Kurakami, Miyoko Hasebe, Kaoru Kinugawa, Takao Kiriyama, Tesseki Izumi, Masato Kasahara, and Kazuma Sugie. 2026. "Home-Based REM Sleep Without Atonia in Patients with Parkinson’s Disease: A Post Hoc Analysis of the ZEAL Study" NeuroSci 7, no. 1: 6. https://doi.org/10.3390/neurosci7010006

APA Style

Kataoka, H., Isogawa, M., Nanaura, H., Kurakami, H., Hasebe, M., Kinugawa, K., Kiriyama, T., Izumi, T., Kasahara, M., & Sugie, K. (2026). Home-Based REM Sleep Without Atonia in Patients with Parkinson’s Disease: A Post Hoc Analysis of the ZEAL Study. NeuroSci, 7(1), 6. https://doi.org/10.3390/neurosci7010006

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