The Treatment of Sleep Disorders in Parkinson’s Disease: From Research to Clinical Practice

Loddo, Giuseppe; Calandra-Buonaura, Giovanna; Sambati, Luisa; Giannini, Giulia; Cecere, Annagrazia

doi:10.3389/fneur.2017.00042

Cited by 108 publications

(136 citation statements)

References 179 publications

(191 reference statements)

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“…Insomnia is thought to be the most common sleep disorder in PD and its prevalence ranges from 27% to 80%, part of the variability being due to differences in diagnostic criteria (5, 6). Sleep maintenance insomnia, including frequent awakenings/sleep fragmentation, is the most prevalent sleep disturbance in PD patients (81%) (5, 7).…”

Section: Introductionmentioning

confidence: 99%

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Sleep and Circadian Rhythm Disorders in Parkinson’s Disease

Gros

Videnović

2017

Curr Sleep Medicine Rep

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Purpose of review Sleep disorders are among the most challenging non-motor features of Parkinson’s disease (PD) and significantly affect quality of life. Research in this field has gained recent interest among clinicians and scientists and is rapidly evolving. This review is dedicated to sleep and circadian dysfunction associated with PD. Recent findings Most primary sleep disorders may co-exist with PD; majority of these disorders have unique features when expressed in the PD population. Summary We discuss the specific considerations related to the common sleep problems in Parkinson’s disease including insomnia, rapid eye movement sleep behavior disorder, restless legs syndrome, sleep disordered breathing, excessive daytime sleepiness and circadian rhythm disorders. Within each of these sleep disorders, we present updated definitions, epidemiology, etiology, diagnosis, clinical implications and management. Furthermore, areas of potential interest for further research are outlined.

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Section: Introductionmentioning

confidence: 99%

“…Sleep maintenance insomnia, including frequent awakenings/sleep fragmentation, is the most prevalent sleep disturbance in PD patients (81%) (5, 7). Difficulty falling asleep (18%) and early awakenings (40%) are also encountered (5, 6). …”

Section: Introductionmentioning

confidence: 99%

Sleep and Circadian Rhythm Disorders in Parkinson’s Disease

Gros

Videnović

2017

Curr Sleep Medicine Rep

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“…The application of melatonin agonists (e.g., Ramelteon) might be a promising approach. More recent studies have revealed that rivastigmine might be another suitable pharmaceutical option for refractory RBD, as observed in small RCTs …”

Section: Established Therapiesmentioning

confidence: 87%

“…More recent studies have revealed that rivastigmine might be another suitable pharmaceutical option for refractory RBD, as observed in small RCTs. 37 CURRENT DEVELOPMENTS: DISEASE-MODIFYING APPROACHES General approaches…”

Section: Nonmotor Symptomsmentioning

confidence: 99%

Progress of Pharmacological Approaches in Parkinson's Disease

Zeuner

Schäffer

Hopfner

et al. 2019

Clin Pharma and Therapeutics

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The progressive neurodegenerative process in Parkinson's disease (PD) is not restricted to dopaminergic midbrain neurons but involves the entire nervous system. In this review, we outline established treatment options at different disease stages and address new therapeutic approaches. These include, based on recent advances in the understanding of the pathophysiology of PD, genetic and disease‐modifying approaches to reduce abnormal accumulation and aggregation of alpha‐synuclein (aSYN), mitochondrial dysfunction, and dysfunction of lysosomal proteins. Moreover, we highlight clinical trials to reduce neuroinflammation and increase neurorestoration.

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“…В случаях ночной гипокинезии (пробуждения на фоне затруднений при поворотах в постели, ощущения «скованности») целесообразно повысить вечернюю дозу стандартного препарата, содержащего леводопу, либо назначить препараты, усиливающие ее дофаминергический эффект (энтакапон, ингибитор моноаминоксидазы В) [47][48][49][50]. Коррекции ночных симптомов БП и улучшению сна способствуют АДР прамипексол, ропинирол [51][52][53]. Однако на фоне приема АДР дневная сонливость может усиливаться, в связи с чем препараты этой группы рекомендуются преимущественно для вечернего приема в виде непролонгированной лекарственной формы.…”

Section: таблица 3 с р а в н е н и е п а ц и е н т о в с с н п -с б unclassified

Nighttime sleep disorders in patients with daytime sleepiness in Parkinson s disease

Nodel

Shevtsova

Ковров

et al. 2018

Nevrologiâ, nejropsihiatriâ, psihosomatika

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Daytime sleepiness is one of the clinically significant non-motor manifestations of Parkinson's disease (PD). One of its insufficiently studied aspects is a relationship between daytime sleepiness and nighttime sleep disorders.Objective:to clarify the clinical characteristics of PD in patients with different types of daytime sleepiness and to estimate of the ratio of daytime sleepiness to clinical and polysomnographic characteristics of nighttime sleep in patients with advanced stages of PD.Patients and methods. The investigation included 110 patients (56 men and 54 women) (mean age, 63.78+0.6 years) with PD (Hoehn and Yahr stage 2.6+0.2; disease duration, 6.3+3.2 years) without dementia. All the patients received therapy with levodopa at a mean daily dose of 667.8 mg; 98 of them had the drug in combination with dopamine receptor agonists at a stable dose. The unified PD rating scale, the PD sleep scale (PDSS), and the Epworth sleepiness scale (ESS) were applied. Nocturnal polysomnography (PSG) and the multiple sleep latency test (MSLT) were performed.Results and discussion. There was daytime sleepiness in 44% of the patients: permanent sleepiness in 15%, sudden daytime sleep attacks (along with low daytime sleepiness (ESS) in 14%, and permanent drowsiness concurrent with sleep attacks in 15%. The PSG findings showed a decrease in sleep efficiency, an increase in the duration of the first stage of sleep, a reduction in the duration of the second and third sleep stages, an extension of rapid eye movement (REM) sleep latency, and frequent awakenings (sleep fragmentation). PSG also demonstrated REM sleep behavior disorders (RBD) in half of the examinees.Patients with sleep attacks differed from those with permanent drowsiness without sleep attacks with more severe sleep disorders (PDSS) and shorter sleep latency (MSLT). Patients with the RBD phenomenon had shorter sleep latency (MTLS) than those without this parasomnia. Patients with moderate or severe sleepiness (ESS scores of >10) differed from those with milder drowsiness (ESS scores of 410) and a lower representation of the third sleep stage.Conclusion.There is evidence for the association of daytime sleepiness in PD with reduced efficiency, changes in the nighttime sleep pattern, and RBD.

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The Treatment of Sleep Disorders in Parkinson’s Disease: From Research to Clinical Practice

Cited by 108 publications

References 179 publications

Sleep and Circadian Rhythm Disorders in Parkinson’s Disease

Sleep and Circadian Rhythm Disorders in Parkinson’s Disease

Progress of Pharmacological Approaches in Parkinson's Disease

Nighttime sleep disorders in patients with daytime sleepiness in Parkinson s disease

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