Progress and Prospects in Parkinson's Research/Therapy/Symptomatic Relief/Sleep Disturbance
Sleep occupies up to a third of the average individual's existence and is believed to fulfil a number of essential biological functions:-
1. It enables the body to replenish its energy reserves.
2. It gives the immune system a clear run to do some housework - eliminating toxins, disposing of potentially harmful chemical leftovers such as free radicals.
3. Integrating short term memories with long term ones and deleting obsolete neuronal connections.
The study of sleep has led to the development of a unique glossary of terms, a shortened version of which is given here:-
Apnoea Suden cessation of breathing.
Bruxism - Teeth grinding while sleeping.
Circadian Rhythm Normal 24 hour sleep pattern.
Delayed Sleep Phase Syndrome (DSPS) - Abnormal sleep pattern e.g jet lag.
Enuresis - Bed wetting.
Excessive daytime sleepiness (EDS) - See Narcolepsy.
Hypnophobia - Fear of falling asleep.
Hypopnea - Shallow breathing during sleep.
Hypersomnia - Excessive amounts of sleep.
Insomnia - Abnormal wakefulness.
Narcolepsy - Abrupt daytime periods of sleep.
Nocturia - Frequent need to urinate during the night.
Non-Rapid Eye movement (NREM) - Eyes are immobile.
Periodic limb movement disorder (PLMD) - Sudden jerking of an arm or leg while sleeping.
Rapid Eye Movement (REM) - Self-explanatory. Usually occurs when dreaming is taking place.
REM Sleep Disorder (RSD) Acting out violent or dramatic dreams when asleep.
Restless Legs Syndrome - Inability to keep the legs still when lying down.
Videnovic and Golombek  evaluated PD sleep disorders:-
Co-existent primary sleep disorders, medication side effects, overnight re-emergence of motor symptoms, and primary neurodegeneration itself, are main causes of sleep disruption and excessive daytime sleepiness among patients with PD. Increasing body of evidence suggests that the circadian system becomes dysregulated in PD, which may lead to poor sleep and alertness.
Bliwise et al  tested the sleep patterns of 63 PD patients in a sleep laboratory and concluded:-
A sizeable proportion of PD patients demonstrated REM [Rapid Eye Movements] sleep and daytime sleep tendency during daytime nap testing. These data confirm similarities in REM intrusions between narcolepsy and PD, perhaps suggesting parallel neurodegenerative conditions of hypocretin deficiency.
Sonka and Susta  evaluated Excessive Daytime Sleepiness (EDS) in PD patients and concluded:-
The central nervous system stimulants modafinil and methylphenidate seem to work well in most cases and in narcolepsy and Parkinson's disease; sodium oxybate also has notable therapeutic value.
Howell , M.J. Neurotherapeutics. Abstract
Parasomnias: An Updated Review.
The National Sleep Foundation (USA) publishes an analysis of sleep disorders associated with PD.
Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Sleep.
This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance.
- Videnovic, A and Golombek, D. (2012) Abstract Exp Neurol. 2012 Circadian and sleep disorders in Parkinson's disease. http://www.ncbi.nlm.nih.gov/pubmed/22935723
- Bliwise, D.L.; Trotti, L.M; Juncos,J.J.; Factor, S.A.; Freeman, A. and Rye, D.B. (2012) Abstract Parkinsonism Relat. Disord. 2012 Daytime REM sleep in Parkinson's disease. http://www.ncbi.nlm.nih.gov/pubmed/22939103
- Sonka, K. and Susta, M. (2012) Abstract Ther. Adv. Neurol. Disord. (5) 297-305.Diagnosis and management of central hypersomnias. http://www.ncbi.nlm.nih.gov/pubmed/22973425