Sleep Issues in Parkinson's Disease and Their Management

Oct 8, 2020Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics

Sleep Problems and How to Manage Them in Parkinson's Disease

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Abstract

Parkinson's disease is associated with multiple sleep disorders that can significantly reduce sleep quality and overall quality of life.

Motor and nonmotor symptoms of Parkinson's disease can disrupt sleep pathways in the central nervous system.
Rapid eye movement sleep behavior disorder can lead to self-injury or injury to partners during the night.
Restless legs syndrome may cause insomnia and reduce sleep quality due to discomfort and the urge to move the legs before sleep.
Excessive daytime sleepiness is common in Parkinson's disease and negatively impacts quality of life while increasing fall risk.
Obstructive sleep apnea can lead to frequent awakenings during sleep and contribute to excessive daytime sleepiness.
Circadian rhythm dysfunction can alter normal sleep and wake times, leading to further sleep disruption.

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Parkinson's disease (PD) is an alpha-synucleinopathy that leads to prominent motor symptoms including tremor, bradykinesia, and postural instability. Nonmotor symptoms including autonomic, neurocognitive, psychiatric symptoms, and sleep disturbances are also seen frequently in PD. The impact of PD on sleep is related to motor and nonmotor symptoms, in addition to the disruption of the pathways regulating sleep by central nervous system pathology. Rapid eye movement sleep behavior disorder is a parasomnia that can lead to self-injury and/or injury to partners at night. Restless legs syndrome is a subjective sensation of discomfort and urge to move the legs prior to falling asleep and can lead to insomnia and reduced sleep quality. Excessive daytime sleepiness is common in PD and exerts a negative impact on quality of life in addition to increasing the risk of falls. Obstructive sleep apnea is a breathing disorder during sleep that can cause frequent awakenings and excessive daytime sleepiness. Circadian rhythm dysfunction can lead to an advanced or delayed onset of sleep in patients and create disruption of normal sleep and wake times. All of these disorders are common in PD and can significantly reduce sleep quantity, sleep quality, or quality of life for patients and caretakers. Treatment approaches for each of these disorders are distinct and should be individualized to the patient. We review the literature regarding these common sleep issues encountered in PD and their treatment options.

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Sleep Issues in Parkinson's Disease and Their Management

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