Sleep Disorders Associated with Parkinson's Disease: Role of Dopamine, Epidemiology, and Clinical Scales of Assessment

ABSTRACTSleep dysfunction is common among patients with Parkinson's disease and occurs in approximately two thirds of patients. The problems range from nocturnal issues such as difficulty with sleep initiation, sleep fragmentation, disturbance of circadian rhythm, and rapid eye movement sleep behavior disorder, to daytime problems such as excessive daytime sleepiness. Frequent nighttime awakening and sleep disruption are the most common sleep problems in Parkinson's disease. Dopamine plays an important role in maintaining wakefulness. To improve sleep in Parkinson's disease, it is important to achieve the critical balance of adequate dopaminergic therapy and control of symptoms. Increased dopaminergic agents can cause dyskinesias and painful dystonia, and undertreatment can cause nighttime akinesia, rigidity, and worse quality of sleep. Other nondopaminergic drugs commonly used in Parkinson's disease can also affect sleep. In patients with advanced Parkinson's disease, deep brain stimulation of the subthalamic nucleus has a favorable impact on sleep quality and sleep architecture.

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Current Update on Clinically Relevant Sleep Issues in Parkinson’s Disease: A Narrative Review

Journal of Parkinson s Disease ◽

10.3233/jpd-202425 ◽

2021 ◽

pp. 1-22

Author(s):

Keisuke Suzuki

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Disturbances ◽

Sleep Problems ◽

Psychiatric Symptoms ◽

Behavior Disorder ◽

Narrative Review ◽

Nonmotor Symptoms ◽

Sleep Behavior

Sleep disturbances are among the common nonmotor symptoms in patients with Parkinson’s disease (PD). Sleep can be disrupted by nocturnal motor and nonmotor symptoms and other comorbid sleep disorders. Rapid eye movement sleep behavior disorder (RBD) causes sleep-related injury, has important clinical implications as a harbinger of PD and predicts a progressive clinical phenotype. Restless legs syndrome (RLS) and its related symptoms can impair sleep initiation. Excessive daytime sleepiness (EDS) is a refractory problem affecting patients’ daytime activities. In particular, during the COVID-19 era, special attention should be paid to monitoring sleep problems, as infection-prevention procedures for COVID-19 can affect patients’ motor symptoms, psychiatric symptoms and sleep. Therefore, screening for and managing sleep problems is important in clinical practice, and the maintenance of good sleep conditions may improve the quality of life of PD patients. This narrative review focused on the literature published in the past 10 years, providing a current update of various sleep disturbances in PD patients and their management, including RBD, RLS, EDS, sleep apnea and circadian abnormalities.

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Blood RNA biomarkers in prodromal PARK4 and rapid eye movement sleep behavior disorder show role of complexin 1 loss for risk of Parkinson's disease

Disease Models & Mechanisms ◽

10.1242/dmm.028035 ◽

2017 ◽

Vol 10 (5) ◽

pp. 619-631 ◽

Cited By ~ 13

Author(s):

Suna Lahut ◽

Suzana Gispert ◽

Özgür Ömür ◽

Candan Depboylu ◽

Kay Seidel ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Eye Movement ◽

Behavior Disorder ◽

Rapid Eye Movement ◽

Rapid Eye Movement Sleep ◽

Sleep Behavior ◽

Rna Biomarkers

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Sleep problems affect quality of life in Parkinson's disease along disease progression

Sleep Medicine ◽

10.1016/j.sleep.2021.02.036 ◽

2021 ◽

Vol 81 ◽

pp. 307-311 ◽

Cited By ~ 1

Author(s):

Claudio Liguori ◽

Valentino De Franco ◽

Rocco Cerroni ◽

Matteo Spanetta ◽

Nicola Biagio Mercuri ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Progression ◽

Sleep Problems

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Sweet or Bland Dreams? Taste Loss in Isolated REM ‐Sleep Behavior Disorder and Parkinson's Disease

Movement Disorders ◽

10.1002/mds.28692 ◽

2021 ◽

Author(s):

Milan Nigam ◽

Ines Ayadi ◽

Camille Noiray ◽

Ana Catarina Branquino‐Bras ◽

Erika Herraez Sanchez ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rem Sleep ◽

Rem Sleep Behavior Disorder ◽

Behavior Disorder ◽

Sleep Behavior

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Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome

Brain Sciences ◽

10.3390/brainsci11040416 ◽

2021 ◽

Vol 11 (4) ◽

pp. 416

Author(s):

Carla Piano ◽

Francesco Bove ◽

Delia Mulas ◽

Enrico Di Stasio ◽

Alfonso Fasano ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Cortex ◽

Clinical Outcome ◽

Motor Cortex Stimulation ◽

Dopaminergic Therapy

Previous investigations have reported on the motor benefits and safety of chronic extradural motor cortex stimulation (EMCS) for patients with Parkinson’s disease (PD), but studies addressing the long-term clinical outcome are still lacking. In this study, nine consecutive PD patients who underwent EMCS were prospectively recruited, with a mean follow-up time of 5.1 ± 2.5 years. As compared to the preoperatory baseline, the Unified Parkinson’s Disease Rating Scale (UPDRS)-III in the off-medication condition significantly decreased by 13.8% at 12 months, 16.1% at 18 months, 18.4% at 24 months, 21% at 36 months, 15.6% at 60 months, and 8.6% at 72 months. The UPDRS-IV decreased by 30.8% at 12 months, 22.1% at 24 months, 25% at 60 months, and 36.5% at 72 months. Dopaminergic therapy showed a progressive reduction, significant at 60 months (11.8%). Quality of life improved by 18.0% at 12 months, and 22.4% at 60 months. No surgical complication, cognitive or behavioral change occurred. The only adverse event reported was an infection of the implantable pulse generator pocket. Even in the long-term follow-up, EMCS was shown to be a safe and effective treatment option in PD patients, resulting in improvements in motor symptoms and quality of life, and reductions in motor complications and dopaminergic therapy.

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