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左旋多巴和多巴胺激动剂对帕金森病睡眠障碍影响的概述。

An overview of the effects of levodopa and dopaminergic agonists on sleep disorders in Parkinson's disease.

机构信息

Division of Experimental Medicine, Glen Site, McGill University Health Centre, Montréal, Québec, Canada.

Montreal Neurological Institute, McGill University Health Centre, Montréal, Québec, Canada.

出版信息

J Clin Sleep Med. 2023 Jun 1;19(6):1133-1144. doi: 10.5664/jcsm.10450.

Abstract

UNLABELLED

Sleep disorders are among the most common nonmotor symptoms in Parkinson's disease and are associated with reduced cognition and health-related quality of life. Disturbed sleep can often present in the prodromal or early stages of this neurodegenerative disease, rendering it crucial to manage and treat these symptoms. Levodopa and dopaminergic agonists are frequently prescribed to treat motor symptoms in Parkinson's disease, and there is increasing interest in how these pharmacological agents affect sleep and their effect on concomitant sleep disturbances and disorders. In this review, we discuss the role of dopamine in regulating the sleep-wake state and the impact of neurodegeneration on sleep. We provide an overview of the effects of levodopa and dopaminergic agonists on sleep architecture, insomnia, excessive daytime sleepiness, sleep-disordered breathing, rapid eye movement sleep behavior disorder, and restless legs syndrome in Parkinson's disease. Levodopa and dopaminergic drugs may have different effects, beneficial or adverse, depending on dosing, method of administration, and differential effects on the different dopamine receptors. Future research in this area should focus on elucidating the specific mechanisms by which these drugs affect sleep in order to better understand the pathophysiology of sleep disorders in Parkinson's disease and aid in developing suitable therapies and treatment regimens.

CITATION

Scanga A, Lafontaine A-L, Kaminska M. An overview of the effects of levodopa and dopaminergic agonists on sleep disorders in Parkinson's disease. . 2023;19(6):1133-1144.

摘要

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睡眠障碍是帕金森病中最常见的非运动症状之一,与认知能力下降和健康相关的生活质量下降有关。睡眠障碍在这种神经退行性疾病的前驱期或早期经常出现,因此对这些症状进行管理和治疗至关重要。左旋多巴和多巴胺激动剂常用于治疗帕金森病的运动症状,人们越来越关注这些药物如何影响睡眠以及它们对同时存在的睡眠障碍和疾病的影响。在这篇综述中,我们讨论了多巴胺在调节睡眠-觉醒状态中的作用以及神经退行性变对睡眠的影响。我们概述了左旋多巴和多巴胺激动剂对帕金森病睡眠结构、失眠、白天过度嗜睡、睡眠呼吸障碍、快速眼动睡眠行为障碍和不宁腿综合征的影响。左旋多巴和多巴胺药物的作用可能因剂量、给药方式以及对不同多巴胺受体的不同影响而不同,有益或有害。该领域的未来研究应侧重于阐明这些药物影响睡眠的具体机制,以便更好地理解帕金森病睡眠障碍的病理生理学,并有助于开发合适的治疗方法和治疗方案。

引文

Scanga A, Lafontaine A-L, Kaminska M. 左旋多巴和多巴胺激动剂对帕金森病睡眠障碍的影响概述。. 2023;19(6):1133-1144.

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