Objective: a complete study of sleep disorders and their adequate treatment

Background: Sleep and wake disturbances are the second most common non-motor symptom of Parkinson’s disease (PD) and are observed in 60–90% of patients. Sleep and wakefulness disorders in PD can be represented by insomnia, hypersomnia, parasomnia and sleep breathing disorders.clinically significant causes of nocturnal sleep disturbances are symptoms of parkinsonism, dystonic muscle spasms or cramps, sensory (paresthesia/pain, restless legs syndrome – RLS), emotional disorders, akathisia, nocturia. Strengthening of the symptoms of parkinsonism, dystonia at night is especially characteristic of patients with motor fluctuations, the initial manifestations of the “dose wear” phenomenon.while taking dopaminergic drugs (not only dopamine receptor agonists, but also levodopa drugs, as well as catechol-O-methyltransferase inhibitors), seizures may become more pronounced. Drowsiness associated with taking dopaminergic drugs is more often manifested during dose titration, but decreases with a stable dose.A decrease in melatonin secretion, along with a delay in reaching the peak of secretion, is noted in elderly patients with insomnia compared with the same age population without sleep disturbance. Patients with PD also showed a shift in the nocturnal peak of melatonin release, which may develop as PD progresses and increases in duration and during levodopa therapy.

Method: 20 patients with PD were examined at the Center for Extrapyramidal Diseases.The severity of nocturnal symptoms was assessed using a scale for a comprehensive assessment of factors that disturb sleep in PD.

Results: The most common nocturnal symptoms of PD in the examined patients were nocturia (50.8%), affective disorders (30.4%), akinesia (21.7%) and cramps (11%). Daytime sleepiness was also noted (50.2%).

Conclusion: The severity of nocturnal symptoms depends on the clinical form, severity, and rate of progression of PD. Nocturnal symptoms most often manifested in the advanced stages of PD and in the 6-9th year of the disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-disturbance-and-wakefulness-in-parkinsons-disease/