Objective: To systematically review and examine the effectiveness of nonpharmacological therapies that helpful to sleep disturbances for patients with Parkinson’s disease (PD).

Background: Sleep disturbances are common non-motor symptoms in PD patients. Sleep-related symptoms include sleep fragmentations and excessive daytime sleepiness. These complaints diminish quality of life. To improve quality of sleep, nonpharmacological therapies are being raised attention because of less adverse effects compared to pharmacological treatment. However, research on nonpharmacological therapies for sleep disturbances in patients with PD is limited in quantity.

Methods: A systematic search of eight databases was conducted. Searches were supplemented by hand searching as well. Date restrictions were from January 1st, 2000 to January 1st, 2016. Our method followed PRISMA statement. Risk of bias was assessed with Cochrane Collaboration Risk of Bias Tool.

Results: A total of 8 studies were identified for data extraction. Key domain of interventions was physical interventions, cognitive interventions, and physiologic action using interventions. The most frequently used tool was Epworh Sleepiness Scale (ESS). Four of eight therapies significantly improved quality of sleep as well as other clinical symptoms of PD such as Unified Parkinson’s Disease Rating Scale (UPDRS). Other studies showed (1) no clear effect on sleep (n=1) (2) limited effect on sleep (n=1) (3) effects in both intervention and control group indicating that each intervention had no distinctive effects (n=2). As a result of assessing risk of bias for eight studies, no articles were discarded.

Conclusions: A few nonpharmacological therapies were effective in sleep complaints in PD patients. For example, a bright light therapy showed inconsistent results so that definite conclusions couldn’t be reached yet. Insufficient evidences of other therapies were attributed to unique clinical features of PD such as severity of motor symptoms, or alteration of nervous system. With continuing examining these treatment effects, nonpharmacological therapies may develop distinctive evidence to improve quality of sleep in PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/nonpharmacological-therapies-for-sleep-disturbances-in-parkinsons-disease-patients-a-systematic-review/