Sleep disorders are common in people with Parkinson's disease. These disorders, which increase in frequency throughout the course of the neurodegenerative disease and impair quality of life, include insomnia, excessive daytime sleepiness, circadian disorders, obstructive sleep apnoea, restless legs syndrome, and rapid eye movement (REM) sleep behaviour disorder. The causes of these sleep disorders are complex and multifactorial, including the degeneration of the neural structures that modulate sleep, the detrimental effect of some medications on sleep, the parkinsonian symptoms that interfere with mobility and comfort in bed, and comorbidities that disrupt sleep quality and quantity. The clinical evaluation of sleep disorders include both subjective (eg, questionnaires or diaries) and objective (eg, actigraphy or video polysomnography) assessments. The management of patients with Parkinson's disease and a sleep disorder is challenging and should be individualised. Treatment can include education aiming at changes in behaviour (ie, sleep hygiene), cognitive behavioural therapy, continuous dopaminergic stimulation at night, and specific medications. REM sleep behaviour disorder can occur several years before the onset of parkinsonism, suggesting that the implementation of trials of neuroprotective therapies should focus on people with this sleep disorder.

中文翻译：

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帕金森病患者的睡眠和睡眠障碍


睡眠障碍在帕金森病患者中很常见。这些疾病在神经退行性疾病的整个过程中频率增加并损害生活质量，包括失眠、白天过度嗜睡、昼夜节律紊乱、阻塞性睡眠呼吸暂停、不宁腿综合征和快速眼动 (REM) 睡眠行为障碍。这些睡眠障碍的原因复杂且多因素，包括调节睡眠的神经结构退化、某些药物对睡眠的有害影响、干扰床上活动性和舒适度的帕金森症状，以及破坏睡眠质量和睡眠质量的合并症。数量。睡眠障碍的临床评估包括主观（例如，问卷或日记）和客观（例如，体动记录仪或视频多导睡眠图）评估。帕金森病和睡眠障碍患者的治疗具有挑战性，应该个体化。治疗可以包括旨在改变行为（即睡眠卫生）的教育、认知行为疗法、夜间持续多巴胺能刺激和特定药物。快速眼动睡眠行为障碍可能在帕金森病发病前几年发生，这表明神经保护疗法试验的实施应重点关注患有这种睡眠障碍的人。