Sleep disorders in Parkinson's disease.
Depression, dementia, and physiologic changes contribute to the high prevalence of sleep disturbances in patients with Parkinson's disease (PD). Antiparkinsonian drugs also play a role in insomnia by increasing daytime sleepiness and affecting motor symptoms and depression. Common types of sleep disturbances in PD patients include nocturnal sleep disruption and excessive daytime sleepiness, restless legs syndrome, rapid eye movement sleep behavior disorder, sleep apnea, sleep walking and sleep talking, nightmares, sleep terrors, and panic attacks. A thorough assessment should include complete medical and psychiatric histories, sleep history, and a 1- to 2-week sleep diary or Epworth Sleepiness Scale evaluation. Polysomnography or actigraphy may also be indicated. Treatment should address underlying factors such as depression or anxiety. Hypnotic therapy for sleep disturbances in PD patients should be approached with care because of the risks of falling, agitation, drowsiness, and hypotension. Behavioral interventions may also be useful.
Thorpy
Michael J
MJ
Sleep-Wake Disorders Center, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
D000928:Antidepressive Agents / Q000627:therapeutic use; D001521:Behavior Therapy; D006970:Disorders of Excessive Somnolence / Q000209:etiology; D018491:Dopamine Agonists / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology; D011788:Quality of Life; D012148:Restless Legs Syndrome / Q000209:etiology; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology
D000928:Antidepressive Agents; D018491:Dopamine Agonists; D006993:Hypnotics and Sedatives