To determine the effects of lowering deep brain stimulation (DBS) amplitude during sleep on slow-wave activity and overall sleep quality in individuals with Parkinson’s disease (PD).

Approximately 80% of patients diagnosed with PD experience sleep disturbances, such as insomnia, sleep fragmentation, and REM sleep behavior disorders. Patients often exhibit reduced slow wave activity (SWA) during NREM sleep, which has been linked to more rapid progression of motor and non-motor symptoms. SWA is critical for neurophysiological restoration and facilitates glymphatic clearance of neurotoxic proteins, suggesting a link between sleep disruption and impaired brain waste removal and neurodegeneration. Furthermore, adaptive DBS has been recently explored as a tool to control brain activity during sleep, offering a new avenue to interrogate sleep physiology.

We are conducting a prospective, within-subject trial in PD patients with Medtronic Percept DBS systems. Subjects complete repeated overnight home sleep recordings with the SleepProfiler portable Polysomnography under two conditions: usual clinical amplitude and reduced amplitude (~50% of baseline). Patients are asked to fill out a questionnaire before and after sleep. Conditions are counterbalanced and repeated multiple times. The primary outcome is SWA (0.5–4 Hz) throughout N3 sleep, averaged per night and normalized within-subjects. Secondary outcomes include additional objective sleep measures and subjective morning ratings. Covariates are adjusted by using mixed-effects models to calculate the impact of stimulation condition.

The trial is ongoing with four patients enrolled. Interim results will report feasibility metrics, sleep architecture, and slow-wave variability.

This study examines how modulating DBS amplitude during sleep affects slow-wave activity and broader sleep architecture in Parkinson’s disease, providing new insights into neuromodulation strategies for improving restorative sleep and non-motor outcomes.