Department of Neurology, Dokkyo Medical University, Shimotsuga, Tochigi, Japan.
J Parkinsons Dis. 2021;11(3):971-992. doi: 10.3233/JPD-202425.
Sleep disturbances are among the common nonmotor symptoms in patients with Parkinson's disease (PD). Sleep can be disrupted by nocturnal motor and nonmotor symptoms and other comorbid sleep disorders. Rapid eye movement sleep behavior disorder (RBD) causes sleep-related injury, has important clinical implications as a harbinger of PD and predicts a progressive clinical phenotype. Restless legs syndrome (RLS) and its related symptoms can impair sleep initiation. Excessive daytime sleepiness (EDS) is a refractory problem affecting patients' daytime activities. In particular, during the COVID-19 era, special attention should be paid to monitoring sleep problems, as infection-prevention procedures for COVID-19 can affect patients' motor symptoms, psychiatric symptoms and sleep. Therefore, screening for and managing sleep problems is important in clinical practice, and the maintenance of good sleep conditions may improve the quality of life of PD patients. This narrative review focused on the literature published in the past 10 years, providing a current update of various sleep disturbances in PD patients and their management, including RBD, RLS, EDS, sleep apnea and circadian abnormalities.
睡眠障碍是帕金森病(PD)患者常见的非运动症状之一。睡眠可被夜间运动和非运动症状以及其他合并的睡眠障碍所打乱。快速眼动睡眠行为障碍(RBD)会导致睡眠相关损伤,作为 PD 的先兆具有重要的临床意义,并预测进行性临床表型。不宁腿综合征(RLS)及其相关症状会影响睡眠起始。日间过度嗜睡(EDS)是影响患者日间活动的难治性问题。特别是在 COVID-19 时代,应特别注意监测睡眠问题,因为 COVID-19 的感染预防措施会影响患者的运动症状、精神症状和睡眠。因此,筛查和管理睡眠问题在临床实践中很重要,保持良好的睡眠条件可能会提高 PD 患者的生活质量。本综述重点关注过去 10 年发表的文献,提供了 PD 患者各种睡眠障碍及其管理的最新信息,包括 RBD、RLS、EDS、睡眠呼吸暂停和昼夜节律异常。