Sleep-Related Disorders in Parkinson's Disease: Mechanisms, Diagnosis, and Therapeutic Approaches.

Oscar Arias-Carrión, Emmanuel Ortega-Robles, Daniel Ortuño-Sahagún, Jesús Ramírez-Bermúdez, Aya Hamid, Ali Shalash
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Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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帕金森病的睡眠相关障碍:机制、诊断和治疗方法》。
背景:帕金森病(PD)常伴有一系列睡眠相关障碍,包括失眠、白天过度嗜睡(EDS)、快速眼动睡眠行为障碍(RBD)、不宁腿综合征(RLS)和睡眠相关呼吸障碍(SBD)。这些疾病严重影响了帕金森病患者的生活质量(QoL),并给诊断和治疗带来了独特的挑战:本综述探讨了帕金森病与睡眠相关障碍之间错综复杂的关系,强调了它们的显著特征和潜在的神经生物学机制。综述旨在整合现有知识,优化临床管理,改善患者护理。研究评估了这些疾病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疗法:结果:睡眠相关障碍在帕金森病患者中很普遍。具体而言,RBD的发病率为40%-50%,通常发生在运动症状出现之前,这表明它有可能成为帕金森病的早期标志。尽管这些非运动症状对患者的生活质量有很大影响,但在临床实践中却常常得不到充分认识和处理。药物治疗和非药物干预(如失眠认知行为疗法和生活方式调整)已显示出不同的疗效。设备辅助疗法也显示出改善睡眠相关障碍和整体非运动症状负担的潜力:结论:有效治疗帕金森病患者的睡眠相关障碍需要个性化、综合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错综复杂的关系,旨在开发创新的治疗方法,显著改善患者的预后。
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