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Sleep in Parkinson's disease.

Ambra Stefani1, Birgit Högl2

  • 1Department of Neurology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. ambra.stefani@i-med.ac.at.

Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology
|June 25, 2019
PubMed
Summary

Parkinson's disease disrupts sleep regulation, causing insomnia and daytime sleepiness. It also impairs motor control during sleep, leading to REM sleep behavior disorders and other parasomnias.

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Area of Science:

  • Neurology
  • Sleep Medicine
  • Movement Disorders

Background:

  • Sleep disturbances are prevalent in Parkinson's disease (PD), encompassing a wide range of sleep disorders.
  • PD affects both the regulation of sleep-wake cycles and motor control during sleep.
  • Common sleep issues include insomnia, excessive daytime sleepiness, and parasomnias like REM sleep behavior disorder (RBD).

Purpose of the Study:

  • To review the spectrum of sleep disorders in Parkinson's disease.
  • To highlight diagnostic challenges, particularly in differentiating sleep disorders from PD symptoms and medication effects.
  • To discuss specific considerations for diagnosing and treating sleep disorders in PD patients.

Main Methods:

  • Literature review of sleep disorders in Parkinson's disease.

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  • Analysis of diagnostic complexities and confounding factors.
  • Discussion of differential diagnosis for common sleep complaints in PD.
  • Main Results:

    • Parkinson's disease is associated with insomnia, daytime sleepiness, and parasomnias (e.g., RBD, sleepwalking).
    • Restless legs syndrome and sleep-related breathing disorders are frequently reported, though their prevalence relative to the general population is debated.
    • Accurate diagnosis is challenging due to overlapping symptoms with PD motor features and medication side effects.

    Conclusions:

    • Sleep disturbances are a significant and multifaceted issue in Parkinson's disease.
    • Careful diagnostic evaluation, including distinguishing mimics and utilizing tools like video-polysomnography for RBD, is crucial.
    • Addressing sleep disorders is essential for comprehensive Parkinson's disease management.