Arias-Carrion Oscar, Ortega-Robles Emmanuel, Ortuno-Sahagun Daniel, Ramirez-Bermudez Jesus, Hamid Aya, Shalash Ali
Unidad de Trastornos del Movimiento y Sueño (TMS), Hospital General Dr. Manuel Gea González. Ciudad de México, 14080 México.
Laboratorio de Neuroinmunobiología Molecular, Instituto de Investigación en Ciencias Biomédicas (IICB), Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara. Guadalajara, Jalisco, 44340 México.
CNS Neurol Disord Drug Targets. 2025;24(2):132-143. doi: 10.2174/0118715273314675240820191447.
Parkinson's Disease (PD) is frequently associated with a spectrum of sleep-related disorders, including insomnia, Excessive Daytime Sleepiness (EDS), REM sleep Behaviour Disorder (RBD), Restless Legs Syndrome (RLS), and Sleep-related Breathing Disorders (SBDs). These disorders significantly impact PD patients' Quality of Life (QoL) and present unique diagnostic and therapeutic challenges.
This review has explored the intricate relationship between PD and sleep-related disorders, emphasizing their distinctive features and underlying neurobiological mechanisms. It aimed to consolidate current knowledge to optimize clinical management and improve patient care. The profound impact of these disorders on QoL has been evaluated, along with precise diagnostic methodologies. Additionally, various therapeutic strategies, including pharmacological treatments, nonpharmacological interventions, and device-aided therapies, have been examined.
Sleep-related disorders are prevalent among PD patients. Specifically, RBD exhibits a prevalence of 40-50%, often preceding the onset of motor symptoms, indicating its potential as an early marker of PD. Despite their significant impact on QoL, these non-motor symptoms are frequently under-recognized and inadequately managed in clinical practice. Pharmacological treatments, along with nonpharmacological interventions, like cognitive-behavioral therapy for insomnia and lifestyle modifications, have shown varied efficacy. Device-aided therapies have also demonstrated the potential to improve sleep-related disorders and overall non-motor symptom burden.
Effective management of sleep-related disorders in PD calls for personalized, comprehensive, and multimodal therapeutic approaches. This requires the collaborative efforts of neurologists, sleep specialists, psychiatrists, and other healthcare professionals. Future research should focus on the intricate relationship between PD and sleep disorders, aiming to develop innovative treatments and significantly improve patient outcomes.
帕金森病（PD）常伴有一系列与睡眠相关的障碍，包括失眠、日间过度嗜睡（EDS）、快速眼动睡眠行为障碍（RBD）、不宁腿综合征（RLS）以及睡眠呼吸障碍（SBDs）。这些障碍显著影响帕金森病患者的生活质量（QoL），并带来独特的诊断和治疗挑战。
本综述探讨了帕金森病与睡眠相关障碍之间的复杂关系，强调了它们的独特特征和潜在的神经生物学机制。其目的是整合现有知识，以优化临床管理并改善患者护理。评估了这些障碍对生活质量的深远影响以及精确的诊断方法。此外，还研究了各种治疗策略，包括药物治疗、非药物干预和设备辅助治疗。
睡眠相关障碍在帕金森病患者中很常见。具体而言，快速眼动睡眠行为障碍的患病率为40 - 50%，通常在运动症状出现之前出现，表明其作为帕金森病早期标志物的潜力。尽管这些非运动症状对生活质量有重大影响，但在临床实践中它们常常未得到充分认识和妥善管理。药物治疗以及非药物干预，如针对失眠的认知行为疗法和生活方式改变，已显示出不同的疗效。设备辅助治疗也已证明有改善睡眠相关障碍和总体非运动症状负担的潜力。
有效管理帕金森病患者的睡眠相关障碍需要个性化、全面和多模式的治疗方法。这需要神经科医生、睡眠专家、精神科医生和其他医疗保健专业人员的共同努力。未来的研究应关注帕金森病与睡眠障碍之间的复杂关系，旨在开发创新治疗方法并显著改善患者预后。
