Obstructive Sleep Apnea in Parkinson’s Disease: Motor Subtypes and Effects of Long-acting Levodopa
Bibliographic record
Abstract
Introduction: Parkinson's disease (PD) is characterized by an array of motor and non-motor symptoms, including sleep disruption.PD can be classified into subtypes based on prominent motor symptoms such as tremor dominant (TD) and postural instability/gait difficulty (PIGD) subtypes.Obstructive sleep apnea (OSA) is frequent in PD and contributes to daytime sleepiness and cognitive dysfunction, however, its pathogenesis in PD is unclear.Our previous work suggests that long-acting levodopa (LALD) taken at bedtime may lead to a reduction in respiratory disturbances during sleep in PD patients.The objectives were to explore the differences in sleep structure and OSA within PD motor subtypes and to assess the magnitude of the effect of LALD taken at bedtime on OSA severity (Effect of Long-acting Levodopa on OSA in PD (ELO-PD) trial).Methods: To assess sleep and OSA within the PD motor subtypes, data was used from PD patients with or without OSA (defined as apnea-hypopnea index (AHI) ≥ 15 events/hour on overnight polysomnography) recruited for two of our group's clinical trials, including the ELO-PD trial.Patients were separated into two groups: PIGD and non-PIGD.Multivariable logistic regression models were used to determine if the prevalence of OSA differed across groups.Multivariable linear regression models were used to explore differences in AHI and other respiratory parameters between groups.Sensitivity analyses with three subsets excluding patients on psychoactive medication, levodopa and/or dopaminergic agonists, or both, were performed.The ELO-PD trial was a randomized, crossover placebo-controlled pilot trial.Patients were randomized and allocated to either: group A -LALD followed by placebo or group Bplacebo followed by LALD.Treatment was administered daily at bedtime for two weeks, separated by a two-week washout period.The AHI was determined by polysomnography at screening, at the end of each treatment Abbreviations AASM: American Academy of Sleep Medicine AHI: Apnea-hypopnea index
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".