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睡眠障碍与帕金森病的交集:揭示双向关系

Intersection of Sleep Disorders and Parkinson Disease: Unveiling the Bidirectional Relationship.

作者信息

Antelmi Elena, Lanza Giuseppe, Mogavero Maria Paola, Mingolla Gloria Pompea, Plazzi Giuseppe, Ferini-Strambi Luigi, Ferri Raffaele, Tinazzi Michele

机构信息

Neurology Unit B, AOUI, Verona, Italy.

DIMI Department of Engineering and Medicine of Innovation, University of Verona, Verona, Italy.

出版信息

Mov Disord Clin Pract. 2025 Jan;12(1):11-20. doi: 10.1002/mdc3.14254. Epub 2024 Nov 7.

Abstract

BACKGROUND

Patients with Parkinson's Disease (PD) frequently exhibit non-motor symptoms, particularly sleep disturbances. Sleep disorders in PD patients are intricately linked to the pathogenesis and progression of PD itself, exacerbating neurodegenerative processes and worsening patient quality of life.

OBJECTIVES

This review underscores the significance of sleep disorders in PD, highlighting their prevalence, impact on disease progression, and the bidirectional relationship between sleep disruption and neurodegeneration. It aims to enhance clinician awareness for better diagnosis and management of sleep-related comorbidities in PD.

METHODS

A comprehensive literature search was conducted in PubMed and Scopus using key terms such as "sleep disorders", "Parkinson's disease", "REM sleep behavior disorder", "restless legs syndrome", "insomnia", "obstructive sleep apnea", "excessive daytime sleepiness", "circadian rhythm disorders", "sleep and neurodegeneration".

RESULTS

Sleep disorders are prevalent in PD affecting up to 90% of patients. Conditions such as insomnia, REM sleep behavior disorder, restless legs syndrome, obstructive sleep apnea, excessive daytime sleepiness, and circadian rhythm disorders are commonly reported. These disorders are linked to multifactorial biological mechanisms and are associated with more severe disease phenotypes. Of note, several evidence shows that sleep abnormalities may contribute to neuroinflammation and neurodegeneration, further accelerating the disease course.

CONCLUSIONS

Sleep disturbances are critical non-motor symptoms in PD. Early diagnosis and tailored management of sleep disorders are essential for improving clinical outcomes and potentially offering neuroprotective benefits.

摘要

背景

帕金森病(PD)患者经常出现非运动症状,尤其是睡眠障碍。PD患者的睡眠障碍与PD本身的发病机制和进展密切相关,会加剧神经退行性过程并恶化患者生活质量。

目的

本综述强调了PD中睡眠障碍的重要性,突出了其患病率、对疾病进展的影响以及睡眠中断与神经退行性变之间的双向关系。其目的是提高临床医生的认识,以便更好地诊断和管理PD中与睡眠相关的合并症。

方法

在PubMed和Scopus中使用“睡眠障碍”、“帕金森病”、“快速眼动睡眠行为障碍”、“不宁腿综合征”、“失眠”、“阻塞性睡眠呼吸暂停”、“日间过度嗜睡”、“昼夜节律障碍”、“睡眠与神经退行性变”等关键词进行了全面的文献检索。

结果

睡眠障碍在PD中很常见,影响高达90%的患者。失眠、快速眼动睡眠行为障碍、不宁腿综合征、阻塞性睡眠呼吸暂停、日间过度嗜睡和昼夜节律障碍等情况经常被报道。这些障碍与多因素生物学机制有关,并与更严重的疾病表型相关。值得注意的是,一些证据表明睡眠异常可能导致神经炎症和神经退行性变,进一步加速疾病进程。

结论

睡眠障碍是PD中关键的非运动症状。早期诊断和针对性治疗睡眠障碍对于改善临床结局和潜在提供神经保护益处至关重要。

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