World Parkinson’s Day: Don’t suffer from sleep disorders, let’s work together to create beautiful dreams!

Solve the sleep disorder problem of Parkinson's patients and improve their quality of life.

Parkinson's disease is a common chronic degenerative movement disorder of the central nervous system among middle-aged and elderly people. Together with tumor diseases and cardiovascular and cerebrovascular diseases, it constitutes the three major "killers" that endanger the health of middle-aged and elderly people.

In addition to the well-known motor dysfunction, Parkinson's patients also have non-motor dysfunction symptoms such as sleep disorders, autonomic dysfunction, cognitive impairment and psychiatric symptoms. Among them, the incidence of sleep disorders is 42%-98%, which is a Parkinson's symptom that cannot be ignored. Sleep disorders can occur at any stage of Parkinson's disease, and can even appear earlier than motor symptoms, becoming a prodromal manifestation of Parkinson's disease.

April 11 is the 25th World Parkinson's Day. The theme of our country's publicity is "Comprehensive Treatment, Quality Life". Solving the sleep disorder problem of Parkinson's patients is one of the keys to improving the quality of life of Parkinson's patients. Today, let's take a deeper look at the sleep problems of Parkinson's patients!

Why do Parkinson's patients have sleep disorders?

Sleep disorders in Parkinson's patients mainly include rapid eye movement sleep behavior disorder (RBD), insomnia, daytime sleepiness, restless legs syndrome (RLS) and nocturnal breathing disorders. Some patients may only have one type, while others may have multiple types at the same time.

There are often three reasons for sleep disorders: the first is the most common and easiest to solve, due to the fluctuation of symptoms during the progression of the disease, and the patient's habit of taking medication only during the day, which leads to poor control of nighttime symptoms; the second is the influence of therapeutic drugs, which cause sleep disorders overdue. Such as levodopa preparations, dopamine receptor agonists, anticholinergic drugs and amantadine; the third is the influence of other non-motor symptoms, such as disease progression, aging, etc.

How to solve different types of sleep disorders?

1. Insomnia

It manifests as difficulty falling asleep, frequent awakening or early awakening, and is often accompanied by negative emotions such as anxiety and depression. For this type of sleep disorder, patients can adjust anti-PD related drugs, such as adding levodopa controlled release, long-acting DR agonists, etc., to reduce insomnia caused by insufficient nighttime medication and PD symptoms; at the same time, standardize the time of taking medicine, such as avoiding taking drugs such as selegiline and amantadine after 4 pm. Under the doctor's advice, eszopiclone, melatonin, etc. can be added to help solve sleep problems.

2. Daytime sleepiness

Daytime sleepiness may be caused by dopamine receptor agonists, especially pramipexole. In this case, selegiline can be used in combination to relieve sleepiness symptoms. At the same time, patients are advised to increase outdoor activities, enhance the perception of light, and improve daytime sleepiness.

3. Rapid eye movement disorder

Rapid eye movement disorder may be caused by antidepressants or benzodiazepines. Symptoms include various complex behavioral abnormalities during sleep, such as violent and rough movements. It is more common in men than in women. This type of sleep disorder is often easy to hurt oneself or even the bed partner, so when treating it, the safety of the patient and the bed partner must be considered first, and certain protective measures must be taken. Secondly, clonazepam can be used as a first-line treatment, but it may increase the risk of falling. Melatonin can also be used as a drug treatment option under the doctor's advice.

4. Sleep apnea

Sleep apnea is characterized by repeated apnea or hypopnea during sleep, leading to hypoxemia or hypercapnia. Due to changes in sleep structure, patients will also experience a series of clinical symptoms and even damage multiple organ functions. Continuous positive airway pressure therapy is often used clinically to improve the symptoms of sleep apnea in Parkinson's patients at night, and it can also effectively improve daytime sleepiness.

References

[1]Boeve BF. REM sleep behavior disorder: update review of the core features, the REM sleep behavior disorder neurodegenerative disease association, evolving concepts, controversies, and future directions[J]. Ann NY Acad Sci,2 0 1 0,11 84:15-5 4.

[2]Schenck CH, Boeve BF, Mahowald MW. Delayed emergence of a parkinsonian disorder or dementia in 8 1% of older men initially diagnosed with idiopathic rapid eye movement sleep

behavior disorder:a 1 6-year update on a previously reported series[J].Sleep Med,2 0 1 3,1 4:7 44-7 48.

[3] Neuroscience News. "Parkinson's Disease | Clinical Treatment Strategies for Sleep Disorders in Parkinson's Disease"