Sleep in Parkinson’s Disease

Sleep disturbances are common in Parkinson’s disease and comprise the entire spectrum of sleep disorders. On the one hand regulation of sleep and wakefulness is affected in Parkinson’s disease, leading to the development of disorders, such as insomnia and daytime sleepiness. While on the other hand control of motor activity during sleep is impaired, with subsequent manifestation of parasomnias (mainly REM sleep behavior disorders, but also, albeit more rarely, sleepwalking, and overlap parasomnia). Restless legs syndrome has been reported to be frequent in patients with Parkinson’s disease, although there is no consensus on whether it is more frequent in Parkinson’s disease than in the general population. The same is true for sleep-related breathing disorders. Regarding the diagnosis of sleep disorders in patients with Parkinson’s disease, one of the main challenges is correctly identifying excessive daytime sleepiness as there are many potential confounding factors, for example it is necessary to distinguish sleep-related breathing disorders from medication effects, and to distinguish restless legs syndrome from the concomitant presence of potential mimics specific to Parkinson’s disease, such as akathisia, nocturnal leg cramps, nocturnal hypokinesia, early morning dystonia, etc. The correct diagnosis of REM sleep behavior disorder is also not always easy, and video-polysomnography should be performed in order to exclude mimic-like movements at the end of sleep apneas or violent periodic leg movements of sleep. These aspects and specific considerations about diagnosis and treatment of sleep disorders in patients with Parkinson’s disease will be reviewed.


Article written by Ambra Stefani & Birgit Högl.

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Tracker

The tracker is designed to help you track the amount of time you spend in scheduled exercise each day. Scheduled exercise is activity you have prioritised in your day for health and to help slow your Parkinson’s down. This might include PD Warrior exercise, fast walking, golfing, going to the gym etc. It does not include incidental activity such as housework & gardening (although we hope this increases too). The aim of the tracker is to help you build an exercise habit and to keep you accountable, so try and enter something each day.
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