26 Aug Parkinson’s Disease and Sleep
Sleep disturbances are a common non-motor symptom of Parkinson’s disease (PD) that may cause difficulty falling or staying asleep. Sleep disturbances associated with Parkinson’s include:
- Bed mobility changes,
- Rapid Eye Movement (REM) Behaviour Disorder (RBD),
- Restless Legs Syndrome,
- Sleep apnoea,
- Sleep fragmentation (broken sleep) and
It is still unclear if primary sleep disorders increase the risk of developing PD and/or enhance the rate of progression, or if they arise as a consequence of PD.4
Some tips that may help patients with Parkinson’s disease get a better night sleep:
- Limit daytime naps (also helpful with patients with dementia)
- Avoid caffeine, alcohol, and exercise later in the day
- Limit fluid intake before bed
- Sleep hygiene (regular bedtime and routine, avoid TV/ipads/smartphones before bed)
Brain atrophy in Parkinson’s disease with polysomnography-confirmed REM sleep behaviour disorder
Shady Rahayel, Malo Gaubert, Ronald B Postuma, Jacques Montplaisir, Julie Carrier, Oury Monchi, David Rémillard-Pelchat, Pierre-Alexandre Bourgouin, Michel Panisset, Sylvain Chouinard, Sven Joubert, Jean-François Gagnon; Brain atrophy in Parkinson’s disease with polysomnography-confirmed REM sleep behavior disorder, Sleep, , zsz062, https://doi.org/10.1093/sleep/zsz062
The presence of REM sleep behaviour disorder (RBD) in Parkinson’s disease (PD) is associated with a more severe and aggressive clinical phenotype. REM sleep behaviour disorder (RBD) is characterized by abnormal muscle tone and motor manifestations during REM sleep.1 RBD affects 33% to 46% of Parkinson’s disease (PD) patients according to studies using polysomnography (PSG),2,3 which is mandatory for RBD diagnosis.1
Thirty Parkinson’s disease patients, including 15 patients with RBD, were recruited and compared to 41 healthy controls. PD patients with RBD had extensive cortical abnormalities and shape contraction in the putamen. REM sleep without atonia was also associated in PD with abnormal thalamic shape, extensive cortical thinning, and subtle volume reduction in the temporal region.
Higher Amounts of REM Sleep without Atonia Predict Phenoconversion To Defined Neurodegenerative Disorders in Idiopathic REM Sleep Behaviour Disorder
S J McCarter, J C Feemster, A R McCarter, D J Sandness, P C Timm, L N Teigen, B F Boeve, M H Silber, E K St. Louis, 0660 Higher Amounts of REM Sleep without Atonia Predict Phenoconversion To Defined Neurodegenerative Disorders in Idiopathic REM Sleep Behavior Disorder, Sleep, Volume 41, Issue suppl_1, April 2018, Page A245, https://doi.org/10.1093/sleep/zsy061.659
Idiopathic REM sleep behaviour disorder (iRBD) is a manifestation of prodromal neurodegenerative disease in most older adults. However, biomarkers are needed to predict individualized risk of phenoconversion for accurate prognosis and use in future clinical trials. Whether polysomnographic REM sleep without atonia (RSWA) predicts phenoconversion in iRBD remains uncertain.
Patients with iRBD who developed a defined neurodegenerative disorder had higher amounts of polysomnographic RSWA at iRBD diagnosis compared to those who remained disease-free, driven by motor but not cognitive syndrome phenoconverters. Our findings suggest amount of RSWA at iRBD diagnosis is a useful biomarker to identify risk for phenoconversion.
- American Academy of Sleep Medicine. The International Classification of Sleep Disorders — Third Edition (ICSD-3). Darien, IL: American Academy of Sleep Medicine; 2014.
- Gagnon JF, Bédard MA, Fantini ML, et al. REM sleep behavior disorder and REM sleep without atonia in Parkinson’s disease. Neurology. 2002; 59 (4): 585-589.
- Sixel-Döring F, Trautmann E, Mollenhauer B, Trenkwalder C. Associated factors for REM sleep behavior disorder in Parkinson disease. Neurology. 2011;77 (11): 1048-1054.
- Shen, Y., & Liu, C. F. (2018). Sleep Disorders in Parkinson’s Disease: Present Status and Future Prospects. Chinese medical journal, 131(8), 883–885. doi:10.4103/0366-6999.229903