ABSTRACT
Disorders of sleep and wakefulness occur in about 60-98% of patients with Parkinson's disease (PD). The majority of research on the scale and nature of the disorders was performed in patients treated with antiparkinsonian drugs, and, therefore, the true picture of sleep disorders was interfering with side effects of therapy. The spectrum of these disorders in PD patients is broad and includes insomnia, parasomnia and hypersomnia. The main symptoms of insomnia are difficulty in maintaining sleep, associated with nocturia, rapid eye movement (REM) sleep behavior disorder (RBD), night cramps, akinesia and tremor. The frequency of hypersomnia in PD patients not receiving antiparkinsonian drugs was comparable to that in healthy people. In some studies, hypersomnia is considered as an independent phenomenon of PD, and not associated with the quality of night's sleep or concomitant therapy. Parasomnias in PD patients at the early stage are manifested primarily by REM-sleep behavior disorder (RBD), which has been proven to be a predictor of development of PD. According to our data, insomnia, hypersomnia and RBD were identified in patients who did not receive antiparkinsonian drugs. The polysomnographic study showed the development of RBD in 25% of patients. In the analysis of the anamnesis, it was noted that in 8 cases sleep disorders appeared several years before the first motor symptoms.
