Objective: This meta-analysis aimed to assess the clinical efficacy of various non-pharmacological therapies for PD sleep disorders (PDSD) to inform treatment strategies.

Background: Sleep disorders are among common non-motor symptoms in Parkinson’s disease (PD), significantly impairing patients’ quality of life. While pharmacological treatments exist, they have dependency and side effects. Non-pharmacological therapies are gaining attention, but their efficacy remains unclear.

Method: We searched PubMed, Medline, Web of Science, Cochrane Library, CNKI, VIP, and CBM for randomized controlled trials (RCT) published between February 2015 and February 2025. Interventions included acupuncture, non-invasive neuromodulation, bright light therapy, exercise, cognitive-behavioral therapy, and physical therapies, compared against sham controls or usual care. Primary outcomes were sleep quality (Pittsburgh Sleep Quality Index – PSQI, Epworth Sleepiness Scale – ESS, Parkinson’s Disease Sleep Scale – PDSS, Restless Legs Syndrome Rating Scale – RLSRS). Secondary outcomes included quality of life (Parkinson’s Disease Questionnaire-39-PDQ-39) and polysomnography indicators. Meta-analysis was performed using RevMan 5.3.

Results: Subgroup analyses revealed that non-invasive neuromodulation had the maximum effect size in reducing PSQI scores(P < 0.05). Timed light therapy and exercise rehabilitation had larger effect sizes in reducing ESS scores( P < 0.05). Traditional Chinese acupuncture and herbal baths had the largest effect size in increasing PDSS scores(P < 0.05). Neuromuscular electrical stimulation had a larger effect size in improving RLSRS scores (P < 0.05).

Conclusion: Various non-pharmacological interventions can effectively improve sleep quality and quality of life in PD patients with different types of sleep disorders. Non-invasive neuromodulation, traditional Chinese acupuncture and herbal baths are more effective in improving insomnia, while Timed light therapy and exercise rehabilitation are more effective in reducing EDS. Neuromuscular electrical stimulation is effective in alleviating symptoms of RLS.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effects-of-non-pharmacological-treatments-for-parkinsons-disease-sleep-disorders%ef%bc%9aa-systematic-review-and-meta-analysis/