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Sleep disorders and daytime sleepiness in Parkinson’s disease

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Abstract

Patients with Parkinson’s disease commonly have sleep disturbances that significantly alter quality of life but are often underrecognized. Awareness of the importance of these sleep disorders has been growing, and more research is being conducted. Patients with Parkinson’s disease have difficulties that not only include falling asleep and staying asleep but also include excessive daytime sleepiness and abnormal events during sleep. These sleep disturbances are often multifactorial in nature, resulting from degeneration of the cortical sleep centers to effects of medications taken to treat the motor symptoms associated with Parkinson’s disease. A thorough evaluation should be performed to assess for the presence of sleep disturbances and daytime sleepiness. Many therapeutic strategies can be used to treat sleepiness and sleep disturbances in Parkinson’s disease to improve the patient’s overall health, psychological well-being, and quality of life.

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References and Recommended Reading

  1. Lees AJ, Blackburn NA, Campbell VL: The nighttime problems of Parkinson’s disease. Clin Neuropharmacol 1988, 11:512–519.

    Article  PubMed  CAS  Google Scholar 

  2. Tandberg E, Larsen JP, Karlsen K: A community-based study of sleep disorders patients with Parkinson’s disease. Mov Disord 1998, 13:895–899.

    Article  PubMed  CAS  Google Scholar 

  3. Diederich NJ, Vaillant M, Mancuso G, et al.: Progressive sleep ‘destructuring’ in Parkinson’s disease. A polysomnographic study in 46 patients. Sleep Med 2005, 6:313–318.

    Article  PubMed  Google Scholar 

  4. Borek LL, Kohn R, Friedman JH: Md and sleep in Parkinson’s disease. J Clin Psychiatry 2006, 67:958–963.

    Article  PubMed  Google Scholar 

  5. Kumar S, Bhatia M, Behari M: Sleep disorders in Parkinson’s disease. Mov Disord 2002, 17:775–781.

    Article  PubMed  Google Scholar 

  6. Gneratne NS, Weaver TE, Carter JR, et al.: Functional outcomes of excessive daytime sleepiness in older adults. J Am Geriatr Soc 2003, 51:642–649.

    Article  Google Scholar 

  7. Gjerstad MD, Wentzel-Larsen T, Aarsland D, Larsen JP: Insomnia in Parkinson’s disease: frequency and progression over time. J Neurol Neurosurg Psychiatry 2007, 78:476–479.

    Article  PubMed  CAS  Google Scholar 

  8. Plazzi G: REM sleep behavior disorders in Parkinson’s disease and other Parkinson’s disorders. Sleep Med 2004, 5:195–199.

    Article  PubMed  Google Scholar 

  9. Arnulf I: Excessive daytime somnolence in parkinsonism. Sleep Med Rev 2005, 9:185–200.

    Article  PubMed  Google Scholar 

  10. Montastruc JL, Brefel-Courban C, Senard JM, et al.: Sleep attacks and antiparkinsonian drugs: a pilot prospective pharmacoepidemiologic study. Clin Neuropharmacol 2001, 24:181–183.

    Article  PubMed  CAS  Google Scholar 

  11. Wetter TC, Trenkwalder C, Gershanik O, Hogl B: Polysomnographic measures in Parkinson’s disease: a comparison between patients with and without REM sleep disturbances. Wien Klin Wochenschr 2001, 113:249–253.

    PubMed  CAS  Google Scholar 

  12. Shpirer I, Minovitz A, Klein C, et al.: Excessive daytime sleepiness in patients with Parkinson’s disease: a polysomnography study. Mov Disord 2006, 21:1432–1438.

    Article  PubMed  Google Scholar 

  13. Friedman A: Sleep pattern in Parkinson’s disease. Acta Med Pol 1980, 21:193–199.

    PubMed  CAS  Google Scholar 

  14. Brunner H, Wetter TC, Hogl B, et al.: Microstructure of the non-rapid eye movement sleep electroencephalogram in patients with newly diagnosed Parkinson’s disease: effects of dopaminergic treatment. Mov Disord 2002, 17:928–933.

    Article  PubMed  Google Scholar 

  15. Scaglione C, Vignatelli L, Plazzi G, et al.: REM sleep behavior disorder in Parkinson’s disease: a questionnaire-based study. Neurol Sci 2005, 25:316–321.

    Article  PubMed  CAS  Google Scholar 

  16. Eisensehr I, von Lindeiner H, Jager M, et al.: REM sleep behavior disorder in sleep-disordered patients with versus without Parkinson’s disease: is there a need for polysomnography? J Neurol Sci 2001, 186:7–11.

    Article  PubMed  CAS  Google Scholar 

  17. Nass A, Nass RD: Actigraphic evidence for night-time hyperkinesias in Parkinson’s disease. Int J Neurosci 2008, 118:291–310.

    Article  PubMed  Google Scholar 

  18. Lee MS, Rinne JO, Marsden CD: The pedunculopontine nucleus: its role in the genesis of movement disorders. Yonsei Med J 2000, 41:167–184.

    PubMed  CAS  Google Scholar 

  19. Fronczek R, Overeem S, Lee SY, et al.: Hypocretin (orexin) loss in Parkinson’s diasease. Brain 2007, 130:1577–1585.

    Article  PubMed  Google Scholar 

  20. Thannickal TC, Lai YY, Siegel JM: Hypocretin (orexin) cell loss in Parkinson’s disease. Brain 2007, 130:1586–1595.

    Article  PubMed  Google Scholar 

  21. Yasui K, Inoue Y, Kanbayashi T, et al.: CSF orexin levels in Parkinson’s disease, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal degeneration. J Neurol Sci 2006, 250:120–123.

    Article  PubMed  CAS  Google Scholar 

  22. Zoltoski RK, Velazquez-Moctezuma J, Shiromani PJ, et al.: The relative effects of selective M1 muscarinic antagonists on rapid eye movement sleep. Brain Res 1993, 608:186–190.

    Article  PubMed  CAS  Google Scholar 

  23. Garcia-Borreguero D, Caminero AB, de la Llave Y, et al.: Decreased phasic EMG activity during rapid eye movement sleep in treatment of naive Parkinson’s disease: effects of treatment with levodopa and progression of illness. Mov Disord 2002, 17:934–941.

    Article  PubMed  Google Scholar 

  24. Rye DB: Parkinson’s disease and RLS: the dopaminergic bridge. Sleep Med 2004, 5:317–328.

    Article  PubMed  Google Scholar 

  25. Gjerstad MD, Alves G, Wentzel-Larsen T, et al.: Excessive daytime sleepiness in Parkinson’s disease: is it the drugs or the disease? Neurology 2006, 6:853–858.

    Article  Google Scholar 

  26. Kaynak D, Kiziltan G, Kaynak H, et al.: Sleep and sleepiness in patients with Parkinson’s disease before and after dopaminergic treatment. Eur J Neurol 2005, 12:199–207.

    Article  PubMed  CAS  Google Scholar 

  27. Razmy A, Lang AE, Shapiro CM: Predictors of impaired daytime sleep and wakefulness in patients with Parkinson’s disease treated with older (ergot) vs newer (nonergot) dopamine agonists. Arch Neurol 2004, 61:97–102.

    Article  PubMed  Google Scholar 

  28. Kurth MC, Adler CH, Hilaire MS, et al.: Tolcapone improves motor function and reduces levodopa requirement in patients with Parkinson’s disease experiencing motor fluctuations: a multicenter, double-blind, randomized, placebo-controlled trial. Tolcapone Fluctuator Study Group I. Neurology 1997, 48:81–87.

    PubMed  CAS  Google Scholar 

  29. Hublin C, Partinen M, Heinonen EH, et al.: Selegiline in the treatment of narcolepsy. Neurology 1994, 44:2095–2101.

    PubMed  CAS  Google Scholar 

  30. Thorton C, Dore CJ, Elsworth JD, et al.: The effect of deprenyl, a selective monoamine oxidase B inhibitor, on sleep and md in man. Psychopharmacology 1980, 70:163–166.

    Article  Google Scholar 

  31. Schapira AH: Progress in neuroprotection in Parkinson’s disease. Eur J Neurol 2008, 15(Suppl 1):5–13.

    Article  PubMed  Google Scholar 

  32. Cicolin A, Lopiano L, Zibetti M, et al.: Effects of deep brain stimulation of the subthalamic nucleus on sleep architecture in parkinsonian patients. Sleep Med 2004, 5:207–210.

    Article  PubMed  Google Scholar 

  33. Lyons K, Pahwa R: Effects of bilateral subthalamic nucleus stimulation on sleep, daytime sleepiness, and early morning dystonia in patients with Parkinson’s disease. J Neurosurg 2006, 104:502–505.

    Article  PubMed  Google Scholar 

  34. Zibetti M, Torre E, Cinquepalmi A, et al.: Motor and nonmotor symptom follow-up in parkinsonian patients after deep brain stimulation of the subthalamic nucleus. Eur Neurol 2007, 58:218–223.

    Article  PubMed  CAS  Google Scholar 

  35. Ghorayeb I, Loundou A, Auquier P, et al.: A nationwide survey of excessive daytime sleepiness in Parkinson’s disease in France. Mov Disord 2007, 22:1567–1572.

    Article  PubMed  Google Scholar 

  36. Boddy F, Rowan EN, Lett D, et al.: Subjectively reported sleep quality and excessive daytime somnolence in Parkinson’s disease with and without dementia, dementia with Lewy bodies and Alzheimer’s disease. Int J Geriatr Psychiatry 2007, 22:529–535.

    Article  PubMed  Google Scholar 

  37. Wegelin J, McNamara P, Durso R, et al.: Correlates of excessive daytime sleepiness in Parkinson’s disease. Parkinsonism Rel Disord 2005, 11:441–448.

    Article  Google Scholar 

  38. Monaca C, Duhamel A, Jacquesson JM, Ozsancak C, et al.: Vigilance troubles in Parkinson’s disease: a subjective and objective polysomnographic study. Sleep Med 2006, 7:448–453.

    Article  PubMed  CAS  Google Scholar 

  39. Korner Y, Meindorfner C, Moller JC, et al.: Predictors of sudden onset of sleep. Mov Disord 2004, 19:1298–1305.

    Article  PubMed  Google Scholar 

  40. Manni R, Terzaghi M, Sartori I, et al.: Dopamine agonists and sleepiness in PD: review of the literature and personal findings. Sleep Med 2003, 5:189–193.

    Article  Google Scholar 

  41. Rissling I, Geller F, Bandmann O, et al.: Dopamine receptor gene polymorphisms in Parkinson’s disease patients reporting “sleep attacks.”; Mov Disord 2004, 19:1279–1284.

    Article  PubMed  Google Scholar 

  42. Rissling I, Körner K, Geller F, et al.: Preprohypocretin polymorphism in Parkinson’s disease patients reporting “sleep attacks.” Sleep 2005, 28:871–875.

    PubMed  Google Scholar 

  43. Meindorfner C, Korner Y, Moller JC, et al.: Driving in Parkinson’s disease: mobility, accidents, and sudden onset of sleep at the wheel. Mov Disord 2005, 20:832–842.

    Article  PubMed  Google Scholar 

  44. Uc EY, Rizzo M, Anderson SW, et al.: Driving with distraction in Parkinson’s disease. Neurology 2006, 67:1774–1780.

    Article  PubMed  CAS  Google Scholar 

  45. Comella CL: Sleep disturbances in Parkinson’s disease. Curr Neurol Neurosci Rep 2003, 3:173–180.

    Article  PubMed  Google Scholar 

  46. Hogl B, Saletu M, Brandauer E, et al.: Modafinil for the treatment of daytime sleepiness in Parkinson’s disease: a double-blind, randomized, crossover, placebo-controlled polygraphic trial. Sleep 2002, 25:905–909.

    PubMed  CAS  Google Scholar 

  47. Adler CH, Caviness JN, Hentz JG, et al.: Randomized trial of modafinil for treating subjective daytime sleepiness in patients with Parkinson’s disease. Mov Disord 2003, 18:287–293.

    Article  PubMed  Google Scholar 

  48. Ondo WG, Fayle R, Atassi F, et al.: Modafinil for daytime somnolence in Parkinson’s disease: double blind, placebo controlled prallel trial. J Neurol Neruosurg Psychiatry 2005, 76:1636–1639.

    Article  CAS  Google Scholar 

  49. Brga-Neto P, da Silva-Junior FP, Sueli Monte F, et al.: Snoring and excessive daytime sleepiness in Parkinson’s disease. J Neurol Sci 2004, 217:41–45.

    Article  Google Scholar 

  50. Arnulf I, Konofal E, Merino-Andreu M, et al.: Parkinson’s disease and sleepiness; an integral part of PD. Neurology 2002, 58:1019–1024.

    PubMed  CAS  Google Scholar 

  51. Diederich NJ, Vaillant M, Leischen M, et al.: Sleep apnea syndrome in Parkinson’s disease. A case control study in 49 patients. Mov Disord 2005, 20:1413–1418.

    Article  PubMed  Google Scholar 

  52. Juri C, Chaná P, Tapia J, et al.: Quetiapine for insomnia in Parkinson disease: results from an open-label trial. Clin Neuropharmacol 2005, 28:185–187.

    Article  PubMed  CAS  Google Scholar 

  53. Kunz D, Bes F: Melatonin as a therapy in REM sleep behavior disorder patients: an open-labeled pilot study on the possible influence of melatonin on REM-sleep regulation. Mov Disord 1999, 14:507–511.

    Article  PubMed  CAS  Google Scholar 

  54. Gomez-Esteban JC, Zarranz JJ, Tijero B, et al.: Restless legs syndrome in Parkinson’s disease. Mov Disord 2007, 22:1912–1916.

    Article  PubMed  Google Scholar 

  55. Nomura T, Inoue Y, Miyake M, et al.: Prevalence and clinical characteristics of restless legs syndrome in Japanese patients with Parkinson’s disease. Mov Disord 2006, 21:380–384.

    Article  PubMed  Google Scholar 

  56. Loo HV, Tan EK: Case-control study of restless legs syndrome and quality of sleep in Parkinson’s disease. J Neurol Sci 2008, 266:145–149.

    Article  PubMed  Google Scholar 

  57. Nomura T, Inoue Y, Nakashima K: Clinical characteristics of restless legs syndrome in patients with Parkinson’s disease. J Neurol Sci 2006, 250:39–44.

    Article  PubMed  Google Scholar 

  58. Happe S, Pirker W, Kloch G, et al.: Periodic leg movements in patients with Parkinson’s disease are associated with reduced striatal dopamine transporter binding. J Neurol 2003, 250:83–86.

    Article  PubMed  Google Scholar 

  59. Michaud M, Soucy JP, Chabli A, et al.: SPECT imaging of striatal pre- and postsynaptic dopaminergic status in restless legs syndrome with periodic leg movements in sleep. J Neurol 2002, 249:164–170.

    Article  PubMed  Google Scholar 

  60. Ruottinen HM, Partinen M, Hublin C, et al.: An FDOPA PET study in patients with periodic limb movement disorder and restless legs syndrome. Neurology 2000, 54:502–504.

    PubMed  CAS  Google Scholar 

  61. Allen R: Dopamine and iron in the pathophysiology of restless legs syndrome. Sleep Med 2004, 5:385–391.

    Article  PubMed  Google Scholar 

  62. Pacchetti C, Manni R, Zangaglia R, et al.: Relationship between hallucinations, delusions, and rapid eye movement sleep behavior disorder in Parkinson’s disease. Mov Disord 2005, 20:1439–1448.

    Article  PubMed  Google Scholar 

  63. Hickey MG, Demaerschalk BM, Caselli RJ, et al.: “Idiopathic” rapid-eye-movement sleep behavior disorder is associated with future development of neurodegenerative diseases. Neurologist 2007, 13:98–101.

    Article  PubMed  Google Scholar 

  64. Irazno A, Santamaria J, Rye DB, et al.: Characteristics of REM sleep behavior disorder and that associated with MSA and PD. Neurology 2005, 65:247–252.

    Article  Google Scholar 

  65. Borek LL, Kohn R, Friedman JH: Phenomenology of dreams in Parkinson’s disease. Mov Disord 2007, 22:198–202.

    Article  PubMed  Google Scholar 

  66. Gjerstad MD, Boeve B, Wentzel-Larsen T, et al.: Occurrence of clinical correlates of REM sleep behavior disorder in patients with Parkinson’s disease over time. J Neurol Neurosurg Psychiatry 2008, 79:387–391.

    Article  PubMed  CAS  Google Scholar 

  67. Vendette M, Gagnon JF, Decary A, et al.: REM sleep behavior predicts cognitive impairment in Parkinson disease without dementia. Neurology 2007, 69:1843–1849.

    Article  PubMed  CAS  Google Scholar 

  68. Tan A, Salgado M, Fahn S: Rapid eye movement sleep behavior disorder preceding Parkinson’s disease with therapeutic response to levodopa. Mov Disord 1996, 11:214–216.

    Article  PubMed  CAS  Google Scholar 

  69. Boeve BF, Silber MH, Ferman TJ: Melatonin for treatment of REM sleep behavior disorder in neurologic disorders: results in 14 patients. Sleep Med 2003, 4:281–284.

    Article  PubMed  Google Scholar 

  70. Bruguerolle B, Simon N: Biologic rhythms and Parkinson’s disease: a chronopharmacological approach to considering fluctuations in function. Clin Neuropharmacol 2002, 25:194–201.

    Article  PubMed  Google Scholar 

  71. Willis GL, Turner EJ: Primary and secondary features of Parkinson’s disease improve with strategic exposure to bright light: a case series study. Chronobiol Int 2007, 24:521–537.

    Article  PubMed  Google Scholar 

  72. Paus S, Schmitz-Hubsch T, Wullner U, et al.: Bright light therapy in Parkinson’s disease: a pilot study. Mov Disord 2007, 22:1495–1498.

    Article  PubMed  Google Scholar 

  73. Dowling GA, Mastick J, Colling E, et al.: Melatonin for sleep disturbances in Parkinson’s disease. Sleep Med 2005, 6:459–466.

    Article  PubMed  Google Scholar 

  74. Medeiros CA, Carvalhedo de Bruin PR, Lopes LA, et al.: Effect of exogenous melatonin on sleep and motor dysfunction in Parkinson’s disease: a randomized, double blind, placebo-controlled study. J Neurol 2007, 254:459–464.

    Article  PubMed  CAS  Google Scholar 

  75. Srinivasan V, Pandi-Perumal S, Cardinali D, et al.: Melatonin in Alzheimer’s disease and other neurodegenerative disorders. Behav Brain Funct 2006, 2:15.

    Article  PubMed  CAS  Google Scholar 

  76. Tesei S, Antonini A, Canesi M, et al.: Tolerability of paroxetine in Parkinson’s disease: a prospective study. Mov Disord 2000, 15:986–989.

    Article  PubMed  CAS  Google Scholar 

  77. Cummings JL: Managing psychosis in patients with Parkinson’s disease: a review. N Engl J Med 1999, 240:801–803.

    Article  Google Scholar 

  78. Fernandez HH, Trieschmann ME, Burke MA, et al.: Long-term outcome of quetiapine use for psychosis among parkinsonian patients. Mov Disord 2003, 18:510–514.

    Article  PubMed  Google Scholar 

  79. Shulman LM, Taback RL, Rabinstein AA, Weiner WJ: Non-recognition of depression and other non-motor symptoms in Parkinson’s disease. Parkinsonian Relat Disord 2002, 8:193–197.

    Article  CAS  Google Scholar 

  80. Shulman LM, Wen X, Weiner WJ, et al.: Acupuncture therapy for the symptoms of Parkinson’s disease. Mov Disord 2002, 17:799–802.

    Article  PubMed  Google Scholar 

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  1. Sleep Wake Disorders Center, Montefiore Medical Center, 3411 Wayne Avenue, Bronx, NY, 10467, USA

    Renee Monderer

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  1. Renee Monderer
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  2. Michael Thorpy
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Correspondence to Renee Monderer.

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Monderer, R., Thorpy, M. Sleep disorders and daytime sleepiness in Parkinson’s disease. Curr Neurol Neurosci Rep 9, 173–180 (2009). https://doi.org/10.1007/s11910-009-0026-5

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