ABSTRACT
Sleep disturbances are among the common nonmotor symptoms in patients with Parkinson's disease (PD). Sleep can be disrupted by nocturnal motor and nonmotor symptoms and other comorbid sleep disorders. Rapid eye movement sleep behavior disorder (RBD) causes sleep-related injury, has important clinical implications as a harbinger of PD and predicts a progressive clinical phenotype. Restless legs syndrome (RLS) and its related symptoms can impair sleep initiation. Excessive daytime sleepiness (EDS) is a refractory problem affecting patients' daytime activities. In particular, during the COVID-19 era, special attention should be paid to monitoring sleep problems, as infection-prevention procedures for COVID-19 can affect patients' motor symptoms, psychiatric symptoms and sleep. Therefore, screening for and managing sleep problems is important in clinical practice, and the maintenance of good sleep conditions may improve the quality of life of PD patients. This narrative review focused on the literature published in the past 10 years, providing a current update of various sleep disturbances in PD patients and their management, including RBD, RLS, EDS, sleep apnea and circadian abnormalities.
Subject(s)
Disorders of Excessive Somnolence , Parkinson Disease , REM Sleep Behavior Disorder , Restless Legs Syndrome , Sleep Apnea Syndromes , Sleep Disorders, Circadian Rhythm , COVID-19 , Disorders of Excessive Somnolence/diagnosis , Disorders of Excessive Somnolence/etiology , Disorders of Excessive Somnolence/therapy , Humans , Parkinson Disease/complications , Parkinson Disease/diagnosis , Parkinson Disease/therapy , REM Sleep Behavior Disorder/diagnosis , REM Sleep Behavior Disorder/etiology , REM Sleep Behavior Disorder/therapy , Restless Legs Syndrome/diagnosis , Restless Legs Syndrome/etiology , Restless Legs Syndrome/therapy , Sleep Apnea Syndromes/diagnosis , Sleep Apnea Syndromes/etiology , Sleep Apnea Syndromes/therapy , Sleep Disorders, Circadian Rhythm/diagnosis , Sleep Disorders, Circadian Rhythm/etiology , Sleep Disorders, Circadian Rhythm/therapyABSTRACT
OBJECTIVE: Sleep complaints are frequent after acute COVID-19. Aim of this study was to videopolysomnographically evaluate sleep and sleep disorders after SARS-Cov2 infection. METHODS: Patients with suspected sleep disorders after acute COVID-19 underwent video-polysomnography (v-PSG) at the Sleep Disorders Clinic, Department of Neurology, Medical University Innsbruck. V-PSG was conducted 4.2 (SD = 1.3) months after diagnosis of SARS-CoV-2 infection. RESULTS: Eleven patients [nine men, age 52.5 (SD = 11.7) years; BMI 29 (SD = 5.2) kg/m2] were included. At 60 days follow-up after diagnosis, persisting breathing complaints were present in 7/11 (64%) patients. After v-PSG four patients (36%) were diagnosed with obstructive sleep apnea (OSA). Respiratory frequency during sleep was normal and no tachypnea, thoracoabdominal asynchrony, or periodic deep sighing were detected. Four patients (36%) showed REM sleep without atonia (RWA), and two additional patients showed an RWA index within the highest range of normality. CONCLUSION: We report videopolysomnographic findings in a series of eleven patients after acute COVID-19. A major finding of this study was the presence of isolated RWA, a recognized prodromal stage of RBD, in more than one third of the patients. Future videopolysomnographic investigations including quantification of RWA in patients after COVID-19 will give more insights into a possible acute or post-infectious CNS pathology related to the SARS-CoV-2 infection.