Sleep problems negatively affect around 70 percent of Parkinson's disease patients, a new research shows.
Researchers explain that some patients report disturbed sleep/wake patterns such as difficulty in falling asleep or staying asleep. Others often complain of sudden and involuntary daytime sleep 'attacks.
Moreover, in extreme cases, these patients might show REM-sleep behavior disorder (RBD) in which people report vivid, violent dreams or dream re-enactment, even before motor symptoms appear.
"Diagnosis and effective treatment and management of these problems are essential for improving the quality of life and reducing institutionalization of these patients," said lead author Wiebke Schrempf, MD, Technische Universität Dresden, Faculty of Medicine Carl Gustav Carus, Department of Neurology, Division of Neurodegenerative Diseases, Dresden, Germany, in a press release.
The researchers explain that in some cases there are complexities in treating sleep problems in Parkinson's patients. Those are: the worsening of sleep problems by dopaminergic medications used to treat motor symptoms.
The team said that lower doses of levodopa or dopamine agonists can improve sleep quality to an extent by reducing motor symptoms such as nighttime hypokinesia (decreased body movement), dyskinesia (abnormal voluntary movements), or tremor (involuntary shaking), which interfere with normal sleep. However, these medications have side effects. It can lead to excessive daytime sleepiness.
The presence of other conditions common in PD patients such as depression, dementia, hallucinations, and psychosis may interfere with sleep. Unfortunately, some antidepressants can also impair sleep.
"RBD seems to be a good clinical predictor of emerging neurodegenerative diseases with a high specificity and low sensitivity, whereas other early clinical features of PD, such as olfactory dysfunction and constipation, are less specific," said Dr. Schrempf. "These early clues may help identify PD patients before motor symptoms appear, when disease-modifying therapies may be most beneficial."
The analysis was published in the Journal of Parkinson's Disease.
