Sleep disorders associated with Parkinson's disease: role of dopamine, epidemiology, and clinical scales of assessment.
Sleep 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.
Mehta
Shyamal H
SH
Movement Disorders Program, Department of Neurology, Medical College of Georgia, Augusta, GA 30912, USA. shmehta@mcg.edu
Morgan
John C
JC
Sethi
Kapil D
KD
D000818:Animals; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D046690:Deep Brain Stimulation; D004298:Dopamine / Q000502:physiology*; D015259:Dopamine Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007049:Iatrogenic Disease; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D020919:Sleep Disorders, Intrinsic / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D020531:Subthalamic Nucleus / Q000503:physiopathology; D011795:Surveys and Questionnaires
D000978:Antiparkinson Agents; D015259:Dopamine Agents; D004298:Dopamine