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

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.

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

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S4) ◽  
pp. 6-11 ◽  
Author(s):  
Shyamal H. Mehta ◽  
John C. Morgan ◽  
Kapil D. Sethi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Problems ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Dopaminergic Therapy ◽  
Clinical Scales ◽  
And Control

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.

scholarly journals Parkinson's Disease and Sleep/Wake Disturbances

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Todd J. Swick
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Treatment Options ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Clinical Aspects ◽  
Nonmotor Symptoms ◽  
Sleep Behavior

Parkinson's disease (PD) has traditionally been characterized by its cardinal motor symptoms of bradykinesia, rigidity, resting tremor, and postural instability. However, PD is increasingly being recognized as a multidimensional disease associated with myriad nonmotor symptoms including autonomic dysfunction, mood disorders, cognitive impairment, pain, gastrointestinal disturbance, impaired olfaction, psychosis, and sleep disorders. Sleep disturbances, which include sleep fragmentation, daytime somnolence, sleep-disordered breathing, restless legs syndrome (RLS), nightmares, and rapid eye movement (REM) sleep behavior disorder (RBD), are estimated to occur in 60% to 98% of patients with PD. For years nonmotor symptoms received little attention from clinicians and researchers, but now these symptoms are known to be significant predictors of morbidity in determining quality of life, costs of disease, and rates of institutionalization. A discussion of the clinical aspects, pathophysiology, evaluation techniques, and treatment options for the sleep disorders that are encountered with PD is presented.

scholarly journals REM Sleep Behavior Disorder in Parkinson’s Disease: Effects on Cognitive, Psychiatric, and Functional outcomes

2020 ◽  
Vol 26 (9) ◽  
pp. 894-905
Author(s):  
Zanjbeel Mahmood ◽  
Ryan Van Patten ◽  
Marina Z. Nakhla ◽  
Elizabeth W. Twamley ◽  
J. Vincent Filoteo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Functional Capacity ◽  
Psychiatric Symptoms ◽  
Neuropsychological Functioning ◽  
Visual Learning ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Learning Performance ◽  
Sleep Behavior

AbstractObjective:Rapid eye movement sleep behavior disorder (RBD) affects 33–46% of patients with Parkinson’s disease (PD) and may be a risk factor for neuropsychological and functional deficits. However, the role of RBD on neuropsychological functioning in PD has yet to be fully determined. We, therefore, examined differences in neurocognitive performance, functional capacity, and psychiatric symptoms among nondemented PD patients with probable RBD (PD/pRBD+) and without (PD/pRBD−), and healthy comparison participants (HC).Methods:Totally, 172 participants (58 PD/pRBD+; 65 PD/pRBD−; 49 HC) completed an RBD sleep questionnaire, psychiatric/clinical questionnaires, performance-based and self-reported functional capacity measures, and underwent a comprehensive neuropsychological battery assessing attention/working memory, language, visuospatial function, verbal and visual learning and memory, and executive function.Results:Controlling for psychiatric symptom severity, the PD/pRBD+ group had poorer executive functioning and learning performance than the PD/pRBD− group and poorer neuropsychological functioning across all individual cognitive domains than the HCs. In contrast, PD/pRBD− patients had significantly lower scores than HCs only in the language domain. Moreover, PD/pRBD+ patients demonstrated significantly poorer medication management skills compared to HCs. Both PD groups reported greater depressive and anxiety severity compared to HCs; PD/pRBD+ group also endorsed greater severity of apathy compared to HCs.Conclusions:The presence of pRBD is associated with poorer neuropsychological functioning in PD such that PD patients with pRBD have poorer cognitive, functional, and emotional outcomes compared to HC participants and/or PD patients without pRBD. Our findings underscore the importance of RBD assessment for improved detection and treatment of neuropsychological deficits (e.g., targeted cognitive interventions).

Changes in Nonmotor Symptoms Following an 8-Week Yoga Intervention for People with Parkinson's Disease

2019 ◽  
Vol 29 (1) ◽  
pp. 91-99 ◽  
Author(s):  
Alysha A. Walter ◽  
Em V. Adams ◽  
Marieke Van Puymbroeck ◽  
Brandi M. Crowe ◽  
Enrique Urrea-Mendoza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disturbances ◽  
Neurodegenerative Disorder ◽  
Nonmotor Symptoms ◽  
Yoga Intervention ◽  
Balance Confidence ◽  
Related Quality

Abstract Parkinson's disease (PD) is a neurodegenerative disorder marked by progressive degenerative motor symptoms (e.g., tremors, impaired balance and gait) and nonmotor symptoms (e.g., fatigue, sleep disturbances, pain) that can negatively influence health-related quality of life (HRQoL). Previous studies have shown that yoga for individuals with PD improves balance, strength, and mobility. However, little research has been conducted to determine the effect of yoga on nonmotor symptoms of PD. The purpose of this study was to examine changes in nonmotor symptoms among individuals with PD following an 8-week yoga intervention. Data used for analyses were part of a larger study that researched improvements in motor function for individuals with PD. Participants (N = 27) were randomly assigned to experimental (n = 15) and control (n = 12) groups and completed pre- and postintervention quantitative measures. Within-group improvements were statistically significant for fatigue measured by the Parkinson's Fatigue Scale, balance confidence measured by the Activities Balance Confidence Scale, the belief in one's ability to manage falls measured by the Falls Management Scale, activity constraints measured by the Activities Constraint Questionnaire, and PD-specific quality of life measured by the Parkinson's Disease Questionnaire-8. Across-group changes were statistically significant for activity constraints. Findings indicate yoga may be an efficacious intervention for improving nonmotor symptoms as well as HRQoL for individuals with PD.

Factors related to sleep disturbances for individuals with Parkinson’s disease: a regional perspective

2019 ◽  
Vol 32 (7) ◽  
pp. 827-838
Author(s):  
Rachael Wade ◽  
Nancy A. Pachana ◽  
George Mellick ◽  
Nadeeka Dissanayaka
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Cross Sectional ◽  
Sleep Dysfunction ◽  
Cross Sectional Design ◽  
Positive Correlations

ABSTRACTObjectives:Sleep disturbances negatively impact the quality of life of patients with Parkinson’s disease (PD). While persons living in regional areas are at higher risk of PD, PD is poorly managed in regional communities. This study examined factors associated with sleep problems in PD in a regional context.Design:A mixed-methods cross-sectional design was used.Participants:Patients with PD were recruited from the Queensland Parkinson’s Project database.Measurements:Those who agreed to participate were sent a questionnaire assessing aspects of sleep, depression, anxiety, quality of life, and PD severity. Qualitative information was also gathered. Correlations between variables were examined; thematic analyses were performed for qualitative data.Results:All participants (n = 49) reported sleep disturbances, with 73% (n = 36) reporting sleep disturbance to be problematic. Global sleep dysfunction positively correlated with daytime napping (r = .34, p = .01), watching the clock when unable to sleep (r = .38, p = <.01), staying in bed when unable to sleep (r = .43, p = <.01), and going to bed hungry (r = .31, p = .03) and negatively correlated with daytime exercise (r = -.32, p = .02). Positive correlations were observed between global sleep dysfunction and depression (r = .55, p = <.01), anxiety (r = .31, p = .04), and dysfunctional sleep beliefs (r = .39, p = <.01).Conclusion:There is a clear need for identifying factors related to sleep disturbances in PD for effective management.

scholarly journals Dopamine-Induced Nonmotor Symptoms of Parkinson's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Ariane Park ◽  
Mark Stacy
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Side Effects ◽  
Sleep Disturbances ◽  
Complex Disease ◽  
Sleep Problems ◽  
Motor Symptoms ◽  
Nonmotor Symptoms ◽  
Neuropsychiatric Complications ◽  
Non Motor Symptoms

Nonmotor symptoms of Parkinson's disease (PD) may emerge secondary to the underlying pathogenesis of the disease, while others are recognized side effects of treatment. Inevitably, there is an overlap as the disease advances and patients require higher dosages and more complex medical regimens. The non-motor symptoms that emerge secondary to dopaminergic therapy encompass several domains, including neuropsychiatric, autonomic, and sleep. These are detailed in the paper. Neuropsychiatric complications include hallucinations and psychosis. In addition, compulsive behaviors, such as pathological gambling, hypersexuality, shopping, binge eating, and punding, have been shown to have a clear association with dopaminergic medications. Dopamine dysregulation syndrome (DDS) is a compulsive behavior that is typically viewed through the lens of addiction, with patients needing escalating dosages of dopamine replacement therapy. Treatment side effects on the autonomic system include nausea, orthostatic hypotension, and constipation. Sleep disturbances include fragmented sleep, nighttime sleep problems, daytime sleepiness, and sleep attacks. Recognizing the non-motor symptoms that can arise specifically from dopamine therapy is useful to help optimize treatment regimens for this complex disease.

scholarly journals Sleep Disturbances Associated with Parkinson's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Keisuke Suzuki ◽  
Masayuki Miyamoto ◽  
Tomoyuki Miyamoto ◽  
Masaoki Iwanami ◽  
Koichi Hirata
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Eye Movement ◽  
Sleep Disturbances ◽  
Behavior Disorder ◽  
Rapid Eye Movement ◽  
Rapid Eye Movement Sleep ◽  
Sleep Behavior ◽  
Quality Life ◽  
Impaired Sleep

Sleep disturbances are common problems affecting the quality life of Parkinson's disease (PD) patients and are often underestimated. The causes of sleep disturbances are multifactorial and include nocturnal motor disturbances, nocturia, depressive symptoms, and medication use. Comorbidity of PD with sleep apnea syndrome, restless legs syndrome, rapid eye movement sleep behavior disorder, or circadian cycle disruption also results in impaired sleep. In addition, the involvement of serotoninergic, noradrenergic, and cholinergic neurons in the brainstem as a disease-related change contributes to impaired sleep structures. Excessive daytime sleepiness is not only secondary to nocturnal disturbances or dopaminergic medication but may also be due to independent mechanisms related to impairments in ascending arousal system and the orexin system. Notably, several recent lines of evidence suggest a strong link between rapid eye movement sleep behavior disorder and the risk of neurodegenerative diseases such as PD. In the present paper, we review the current literature concerning sleep disorders in PD.

Sleep Disturbances and Parkinson's Disease

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S4) ◽  
pp. 12-17 ◽  
Author(s):  
Joseph H. Friedman ◽  
Richard P. Millman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorder ◽  
Sleep Disturbances ◽  
Treatment Options ◽  
Well Being ◽  
Sleep Behavior ◽  
Treatment Plans ◽  
Nighttime Sleep

ABSTRACTAlthough Parkinson's disease is defined by its motor symptoms, the symptoms that are most devastating to patients and caregivers are dementia and psychosis. In addition, sleep has a tremendous impact on patient well being and quality of life. Eighty percent to 90% of Parkinson's disease patients have a sleep disorder affecting their ability to fall asleep, ability to stay asleep, dreams, motor activity during sleep, post-sleep behavior, or day-time somnolence. Treatment plans for patients with Parkinson's disease who experience sleep disorders aim to improve nighttime sleep or daytime wakefulness, and treatment options vary by sleep disorder.

scholarly journals Impact of Depression and Anxiety on Dimensions of Health-Related Quality of Life in Subjects with Parkinson’s Disease Enrolled in an Association of Patients

2021 ◽  
Vol 11 (6) ◽  
pp. 771
Author(s):  
Fany Chuquilín-Arista ◽  
Tania Álvarez-Avellón ◽  
Manuel Menéndez-González
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychiatric Symptoms ◽  
Well Being ◽  
Depression And Anxiety ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Parkinson’s disease (PD) is a complex disorder characterized by a wide spectrum of symptoms. Depression and anxiety are common manifestations in PD and may be determinants of health-related quality of life (HRQoL). The objective of this study is to determine the association of depression and anxiety with the dimensions of HRQoL in subjects with PD enrolled in an association of patients. Ninety-five community-based patients with PD diagnosis at different disease stages were studied. HRQoL was assessed using the Parkinson’s Disease Questionnaire (PDQ-39); depression and anxiety were assessed using the Beck Depression Inventory (BDI-II) and the State-Trait Anxiety Inventory (STAI), respectively. Our results showed that depression and anxiety were negatively associated with HRQoL measured by PDSI. Higher motor dysfunction measured by Hoehn and Yahr (H&Y) staging was also associated with worse HRQoL. Depression was the most influential variable in the model. All PDQ-39 dimensions except social support and bodily discomfort were associated with depression. Anxiety was associated with the emotional well-being and bodily discomfort dimensions. These results suggest that physicians should pay attention to the presence of psychiatric symptoms and treat them appropriately.

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