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Treatment of the Sleep Disorders Associated with Parkinson’s Disease

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Neurotherapeutics

Abstract

Sleep disorders are common in patients with Parkinson’s disease (PD), and preliminary work has suggested viable treatment options for many of these disorders. For rapid eye movement sleep behavior disorder, melatonin and clonazepam are most commonly used, while rivastigmine might be a useful option in patients whose behaviors are refractory to the former. Optimal treatments for insomnia in PD have yet to be determined, but preliminary evidence suggests that cognitive–behavioral therapy, light therapy, eszopiclone, donepezil, and melatonin might be beneficial. Use of the wake-promoting agent modafinil results in significant improvement in subjective measures of excessive daytime sleepiness, but not of fatigue. Optimal treatment of restless legs syndrome and obstructive sleep apnea in PD are not yet established, although a trial of continuous positive airway pressure for sleep apnea was recently completed in PD patients. In those patients with early morning motor dysfunction and disrupted sleep, the rotigotine patch provides significant benefit.

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Conflict of Interest

Dr. Trotti has served as a consultant for UCB Pharma. Dr. Bliwise has served or is serving as a consultant for Ferring Pharmaceuticals, Vantia Therapeutics, and the New England Research Institute. Full conflict of interest disclosures are available in the electronic supplementary material for this article.

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  1. Department of Neurology, Emory University School of Medicine, 1841 Clifton Road NE, Atlanta, GA, 30329, USA

    Lynn Marie Trotti & Donald L. Bliwise

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Correspondence to Lynn Marie Trotti.

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Trotti, L.M., Bliwise, D.L. Treatment of the Sleep Disorders Associated with Parkinson’s Disease. Neurotherapeutics 11, 68–77 (2014). https://doi.org/10.1007/s13311-013-0236-z

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