Sleep-wake disturbances in Parkinson's disease: current evidence regarding diagnostic and therapeutic decisions.
Study Goal
The researchers aimed to evaluate the effects of light therapy on motor function and depression in patients with Parkinson's disease.
Results Summary
Initial evidence suggests that light therapy improves motor function and depression in Parkinson's disease patients, though very few controlled studies are available to make definitive recommendations.
Population
Patients with Parkinson's disease experiencing sleep disorders.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
light therapy | increase | motor function | patients with Parkinson's disease | - | improves | #1 |
light therapy | increase | depression | patients with Parkinson's disease | - | improves | #2 |
advice on sleep hygiene | decrease | sleep-wake disturbances | patients with Parkinson's disease | - | should be considered | #3 |
treatment of concomitant depression | decrease | sleep-wake disturbances | patients with Parkinson's disease | - | should be considered | #4 |
careful use of dopaminergic drugs | decrease | sleep-wake disturbances | patients with Parkinson's disease | - | should be considered | #5 |
careful use of hypnosedative agents | decrease | sleep-wake disturbances | patients with Parkinson's disease | - | should be considered | #6 |
Sleep disorders have been frequently reported in patients with Parkinson's disease (PD). However, there is insufficient evidence to guide precise recommendations on some diagnostic and treatment strategies. Here, we review clinical studies dealing with sleep abnormalities in PD and present clinical recommendations. Previous studies describing insomnia, excessive daytime sleepiness, narcolepsy-like episodes, circadian changes, sleep-disordered breathing, rapid eye movement sleep behavior disorder, vivid dreams and restless legs syndrome are evaluated. Longitudinal studies associating sleep disorders with PD onset or clinical deterioration are rare: only one longitudinal study associated daytime sleepiness with PD onset. Evidence suggests that clinical investigations must include direct questioning about depressive symptoms, nocturnal cramps, pain, nocturia and nighttime off periods. A patient interview must be conducted regarding sleep symptoms, including nightmares, abnormal behavior during sleep, snoring, restless legs syndrome and daytime sleepiness. Initial evidence indicates that light therapy improves motor function and depression. Advice on sleep hygiene, the treatment of concomitant depression and the careful use of dopaminergic drugs and hypnosedative agents should be considered. To date, very few controlled studies are available to make a recommendation for the management of sleep-wake disturbances in PD.