Sleep problems may signify Parkinson’s disease

Some sleep issues may indicate future Parkinson’s disease (PD), according to a new review in the Journal of Parkinson’s Disease.

REM-sleep behavior disorder (RBD) “seems to be a good clinical predictor of emerging neurodegenerative diseases with a high specificity and low sensitivity, whereas other early clinical features of PD, such as olfactory dysfunction and constipation, are less specific,” says lead author Wiebke Schrempf, MD, of Dresden, Germany. “These early clues may help identify PD patients before motor symptoms appear, when disease-modifying therapies may be most beneficial.”

RBD is characterized by vivid, violent dreams or dream re-enactment during which the dreamer may shout, laugh or exhibit movements such as kicking and boxing. Those with RBD exhibit intermittent loss of normal muscle relaxation during REM sleep.

As many as 70 percent of people with PD experience sleep problems that negatively affect their quality of life, and sleep problems in those with PD can worsen in later stages of the disease. The review discusses the underlying causes of sleep problems in PD, as well as medications, disease pathology and co-morbidities, and it describes diagnostic tools and treatment options.

“Diagnosis and effective treatment and management of these problems are essential for improving the quality of life and reducing institutionalization of these patients,” Schrempf says.