Parkinson’s disease (PD) and multiple system atrophy (MSA) can be preceded by isolated REM sleep behavior disorder (iRBD). As excessive sighing during wakefulness is a red flag for MSA in individuals with parkinsonism, we measured sighing during slow wave sleep (N3) and REM sleep as potential biomarkers in 73 participants with MSA, 111 with iRBD, 257 with PD, and 115 controls. The number of sighs/hour of N3 (index) was higher in the MSA group than in the other groups. Sighs were rarer in REM sleep than in N3 sleep. A sigh index greater than 3.4/h of N3 was 95% sensitive in discriminating participants with MSA from controls, and a sigh index greater than 0.8 sigh/h of REM sleep was 87% specific in discriminating participants with MSA from controls. MSA participants with (vs. without) sigh were younger, had a lower apnea-hypopnea index (but no more stridor), and had no other difference in motor, autonomic, cognitive, and sensory symptoms. The sigh index could be used for screening for MSA in the millions of middle-aged persons who receive polysomnography for other purposes. Whether sighing in iRBD predicts preferential conversion towards MSA should be measured in a longitudinal study.

帕金森病 (PD) 和多系统萎缩 (MSA) 之前可能会出现孤立性快速眼动睡眠行为障碍 (iRBD)。由于清醒时过度叹息是帕金森病患者患有 MSA 的危险信号，因此我们测量了 73 名 MSA 参与者、111 名 iRBD 参与者、257 名 PD 参与者和 115 名对照组参与者在慢波睡眠 (N3) 和 REM 睡眠期间的叹息，将其作为潜在的生物标志物。 MSA 组的 N3（指数）/小时叹气次数高于其他组。与 N3 睡眠相比，快速眼动睡眠中的叹息较少见。 N3 的叹息指数大于 3.4/h，区分 MSA 参与者与对照组的敏感性为 95%，而 REM 睡眠的叹息指数大于 0.8/h，区分 MSA 参与者与对照组的特异性为 87%。有（与没有）叹息的 MSA 参与者更年轻，呼吸暂停低通气指数较低（但不再出现喘鸣），并且在运动、自主、认知和感觉症状方面没有其他差异。叹气指数可用于筛​​查数以百万计因其他目的而接受多导睡眠监测的中年人的 MSA。 iRBD 中的叹息是否预示着优先转向 MSA 应该在纵向研究中进行衡量。