Many With Parkinson’s Disease Sleep Poorly

Sleep problems may be sign of Parkinson disease

(RxWiki News) People diagnosed with Parkinson’s disease often deal with tremors, stiffness and slow movement. They also may have more than their fair share of a more common complaint.

As many as 70 percent of people with Parkinson’s disease may experience sleep problems, according to a recently published report.

Sleep problems may even be a sign of Parkinson's before it is officially diagnosed, the researchers suggested.

"If you have issues with sleep, see your doctor."

The report’s lead author was Wiebke Schrempf, MD, of Dresden University of Technology in Dresden, Germany.

Parkinson’s disease is the most common neurological disorder after Alzheimer’s disease in western countries. It’s a progressive disease that often leads to difficulty with speech and expression, and slowed movements and tremors.

About 0.3 percent of the population has Parkinson's, according to the lead authors, and the rate rises with age.

Many people with Parkinson's have sleep issues. These issues may involve trouble falling and staying asleep and daytime sleepiness. Parkinson's patients may also have REM-sleep behavior disorder (RBD), a condition involving vivid dreams that patients may act out while sleeping. People with RBD sometimes laugh, shout, box or kick while asleep.

According to the authors of this review, physicians need to screen for these sleep issues in Parkinson's patients.

Many people not yet diagnosed with Parkinson's may first show signs of RBD, the writers of this review noted. If the sleep condition is recognized early enough, these people may be diagnosed with Parkinson's at an early stage, which may lead to better outcomes than people diagnosed later.

The authors pointed out that medications used to control symptoms of Parkinson's can make sleep issues worse. Dopaminergic medications, for example, stimulate the receptors in nerves in the brain that normally would be stimulated by the hormone dopamine, which suppresses tremors that often keep people awake. Typically, such medications might improve patients' sleep, but at high doses, these medications can cause daytime sleepiness, the researchers noted.

People with Parkinson's may also feel depressed, but antidepressants can also impair sleep, these authors noted in their review.

If a person with Parkinson's is very tired during the day, he or she may function even less well than if they slept well at night, the authors added. For example, people with Parkinson's disease can become unsteady when they walk. If they are also tired, their unsteadiness may worsen.

The authors of this review recommended that people with Parkinson's get screened for sleep problems by their doctor. Once the physician is treating Parkinson's and caring for symptoms to the best of his or her ability, he or she can consider how best to help the patient sleep.

"Diagnosis and effective treatment and management of these problems are essential for improving the quality of life and reducing institutionalization of these patients," Dr. Schrempf said in a press release.

This review was published in the July issue of the Journal of Parkinson’s Disease.

The authors disclosed numerous fees received for presentations they made for various pharmaceutical companies.

Review Date: 
July 14, 2014