Sleep and PD

Sleep Disturbances in Parkinson’s Disease

People with Parkinson’s Disease frequently experience a range of sleep problems that differ from those typical in the general population. Common disturbances include:

• Insomnia: Difficulty falling asleep or staying asleep.

• REM Sleep Behavior Disorder (RBD): Acting out dreams during REM sleep due to loss of normal muscle paralysis, which can cause injury to self or bed partner.

• Restless Legs Syndrome (RLS): Urge to move legs often at night, which disturbs sleep.

• Excessive daytime sleepiness: Feeling very sleepy during the day, sometimes to the point of sudden sleep attacks.

• Sleep fragmentation: Frequent waking and disrupted sleep architecture.

These disturbances reduce sleep quality, leading to fatigue and worsening other PD symptoms such as cognitive difficulties and mood changes.

Causes and Mechanisms

Sleep dysfunction arises from several PD-related factors:

• Neurodegeneration in brainstem and hypothalamic areas critical for sleep regulation.

• Effects of dopaminergic and other PD medications can disrupt sleep.

• Motor symptoms such as rigidity and tremor interfering with comfortable sleep.

• Psychiatric symptoms associated with PD like anxiety and depression exacerbate sleep problems.

Approaches to Improve Sleep in Parkinson’s

• Medication Review: Adjustments to PD and other medications can improve sleep quality.

• Behavioral Techniques: Sleep hygiene education, regular sleep schedules, reducing daytime naps.

• Treatment of Specific Disorders: For example, melatonin or clonazepam for REM sleep behavior disorder.

• Light therapy: Shown to improve circadian rhythms and sleep quality in PD.

• Exercise: Regular physical activity helps improve sleep and overall motor symptoms.

• Addressing co-morbidities: Treating sleep apnea, restless legs, or mood disorders.

Health Disclaimer

Sleep disturbances in people with Parkinson’s Disease are complex and individual. Please consult a neurologist or sleep specialist experienced in PD for diagnostic assessments and tailored treatment plans.

Sources

1. Parkinson's Disease: Sleep Disturbances and Fatigue | Sleep Foundation

2. Classification of sleep stages from EEG, EOG and EMG signals by SSNet (ArXiv)

3. End-to-End Automatic Sleep Stage Classification Using Spectral-Temporal Sleep Features (ArXiv)