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Minerva Pneumologica 2004 June;43(2):79-92

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: Italian

Sleep disturbances in Parkinson’s disease

Terzaghi M., Manni R., Zangaglia R., Mancini F., Nappi G., Pacchetti C.

Parkinson's disease is a degenerative disease of the central nervous system. Its prevalence is increasing constantly all over the world, with no substantial differences as regards social class, ethnic origin or gender. Epidemiological estimates say that 500 million people will be affected by Parkinson's in western countries by 2040. Fifteen percent to 20% of Parkinson victims are affected before the age of 40 years,
while the peak of new cases is between 60 and 65, although onset is also very frequent after the age of 70 too. At young ages it takes the form of Parkin's disease, a rare form of monogenic Parkinsonism. It is estimated that in Italy more than 200 000 people are victims of Parkin-son's disease. Although the daytime symptomatology of this disease was fully described at the time of its identification by Sir James Parkinson, attention was turned to the phenomenology of sleep disturbances only comparatively recently. These disturbances are variegated and their presence extends not only to the night-time hours but also to the daytime with a range of expression that goes from excessive daytime somnolence and the presence of sleep attacks to the presence of parasomnias and, at times, hallucinations. The relationships between neuronal degeneration and the decline in the efficiency of the mechanisms that determine the organisation of sleep are many and complex, and the specific anti-Parkinson treatment may have an effect of both control and exacerbation, or induction of sleep disturbances. Nevertheless, some of the modifications to the hypnic pattern observed in subjects with Parkinson's disease could be related to the ageing process more than to modifications in the neurone circuits delegated to regulate the sleep-arousal cycle. The presence of sleep disturbances is associated with a worse quality of life and can have a negative impact on daytime cognitive and motor performances.