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Age and Ageing 2006 35(3):220-228; doi:10.1093/ageing/afj087
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© The Author 2006. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review

Sleep-related problems of Parkinson’s disease

V. Dhawan1, D. G. Healy1, S. Pal2 and K. Ray Chaudhuri1

1 Movement Disorders Unit, Kings College Hospital, University Hospital Lewisham, Guy’s King’s and St Thomas’ School of Medicine, London, UK
2 Institute of Neurology, Queen Square, London, UK

Address correspondence to: K. R. Chaudhuri, 9th floor, Ruskin Wing, King’s College Hospital, Denmark Hill, London SE5 9RS, UK. Fax: (+44) 208 333 3093. Email: chaudhuriray{at}hotmail.com; ray.chaudhuri{at}uhl.nhs.uk

Objective: to define the epidemiology, characteristics and aetiology of nocturnal symptoms and sleep disorders in patients with Parkinson’s disease (PD) and evaluate the available methods for their diagnosis and management.

Methods: a review of the English-language literature pertaining to sleep disturbances associated with PD, using the Medline database and bibliographies in relevant articles.

Results: sleep-related problems specific to PD may occur early and even predate the diagnosis of the disease but are generally more frequent and more severe in patients with advanced PD. These problems can seriously compromise patients’ quality of life and lead to impaired functioning in daily activities. Scales designed specifically for the assessment of sleep problems in patients with PD have recently been developed. Evidence base for the treatment of sleep disturbances in PD is poor, and only nocturnal akinesia, excessive day-time sleepiness and rapid eye movement behaviour disorder have been partially addressed.

Conclusions: sleep disorders associated with PD are a common and under-recognised problem. The assessment of sleep should be part of the routine evaluation of patients with PD, and large-scale controlled therapeutic trials are necessary.

Keywords: Parkinson’s disease, sleep disorders, dopaminergic therapy, elderly

Received March 2, 2005; accepted in revised form January 8, 2006.


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