Movement Disorders Unit, Massachusetts General Hospital, Boston, MA, 02114, USA.
Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
Curr Neurol Neurosci Rep. 2018 Apr 19;18(6):29. doi: 10.1007/s11910-018-0838-2.
Parkinson's disease (PD) is the second most common neurodegenerative disorder. Sleep dysfunction is one of the most common non-motor manifestations of PD that has gained significant interest over the past two decades due to its impact on the daily lives of PD patients, poorly understood mechanisms, and limited treatment options. In this review, we discuss the most common sleep disorders in PD and present recent investigations that have broadened our understanding of the epidemiology, clinical manifestations, diagnosis, and treatment of disturbed sleep and alertness in PD.
The etiology of impaired sleep-wake cycles in PD is multifactorial. Sleep dysfunction in PD encompasses insomnia, REM sleep behavior disorder, sleep-disordered breathing, restless legs syndrome, and circadian dysregulation. Despite the high prevalence of sleep dysfunction in PD, evidence supporting the efficacy of treatment strategies is limited. We are at the opportune time to advance our understanding of sleep dysfunction in PD, which will hopefully lead to mechanisms-driven interventions for better sleep and allow us to approach sleep as a modifiable therapeutic target for other non-motor and motor manifestations in PD.
帕金森病(PD)是第二常见的神经退行性疾病。睡眠功能障碍是 PD 最常见的非运动症状之一,由于其对 PD 患者日常生活的影响、机制尚不清楚以及治疗选择有限,在过去二十年中引起了广泛关注。在这篇综述中,我们讨论了 PD 中最常见的睡眠障碍,并介绍了最近的研究进展,这些研究拓宽了我们对 PD 中睡眠和警觉障碍的流行病学、临床表现、诊断和治疗的理解。
PD 中睡眠-觉醒周期障碍的病因是多因素的。PD 中的睡眠功能障碍包括失眠、REM 睡眠行为障碍、睡眠呼吸障碍、不安腿综合征和昼夜节律失调。尽管 PD 中睡眠功能障碍的患病率很高,但支持治疗策略疗效的证据有限。我们正处在一个推进 PD 中睡眠功能障碍理解的最佳时机,这有望为更好的睡眠带来基于机制的干预措施,并使我们能够将睡眠作为 PD 中其他非运动和运动表现的可调节治疗靶点。