The earliest description of sleep problems in Parkinson's disease (PD) dates back to the original description of PD by James Parkinson (1817) who stated, “His attendants observed, that of late the trembling would sometimes begin in his sleep, and increase until it awakened him: when he always was in a state of agitation and alarm” . This may have been the first description of nocturnal tremor and the night-terror or confusional episodes that complicate sleep of people with PD. In spite of sleep dysfunction being a key aspect of the non-motor symptom complex of PD , it is only recently that sleep disturbances related to PD have received specific and focused diagnostic and therapeutic attention [2-9]. The evidence base for treatment of various aspects of sleep dysfunction and its assessment at the bedside by validated tools such as the Parkinson's Disease Sleep Scale (PDSS) have emerged in the last 10 years [10,11]. Studies have also highlighted that the burden of a range of sleep dysfunction that occurs in Parkinson's is a key determinant of quality of life for both patients and carers [12,13]. Awareness has also grown that sleep problems can also affect early untreated PD, and that “poor nights” for people with PD may occur not only in advanced PD but also in early untreated PD, or may even precede the motor symptoms, with significant adverse effects on daytime functioning and functional capacity (such as driving), as well as on the quality of life of the patient [12-16]. Certain sleep disorders may provide useful diagnostic information in differentiating between Parkinsonian syndromes (e.g., multiple system atrophy and progressive supranuclear palsy) and may be important prognostic indicators of neuropsychiatric disturbances and dementia, while others may be precipitated by treatment of PD .
|Title of host publication
|Neuropsychiatric and Cognitive Changes in Parkinson's Disease and Related Movement Disorders: Diagnosis and Management
|Cambridge University Press
|Number of pages
|Published - 1 Jan 2010