背景:帕金森病(PD)通常与一系列睡眠相关疾病有关,包括失眠,白天过度嗜睡(EDS),REM睡眠行为障碍(RBD),不宁腿综合征(RLS),与睡眠相关的呼吸障碍(SBD)。这些疾病显着影响PD患者的生活质量(QoL),并提出了独特的诊断和治疗挑战。
方法:这篇综述探讨了PD与睡眠相关障碍之间的复杂关系,强调其独特的特征和潜在的神经生物学机制。它旨在巩固现有知识,以优化临床管理并改善患者护理。已经评估了这些疾病对QoL的深远影响,以及精确的诊断方法。此外,各种治疗策略,包括药物治疗,非药物干预措施,和设备辅助治疗,已经检查过了。
结果:睡眠相关障碍在PD患者中普遍存在。具体来说,RBD的患病率为40-50%,通常在运动症状发作之前,表明其作为PD的早期标志物的潜力。尽管它们对QoL有重大影响,这些非运动症状在临床实践中经常未得到充分认识和管理.药物治疗,以及非药物干预措施,比如失眠的认知行为疗法和生活方式的改变,表现出不同的功效。设备辅助疗法还显示出改善睡眠相关障碍和总体非运动症状负担的潜力。
结论:有效管理PD患者的睡眠相关疾病需要个性化,全面,和多模式治疗方法。这需要神经学家的共同努力,睡眠专家,精神病医生,和其他医疗保健专业人员。未来的研究应该集中在PD和睡眠障碍之间的复杂关系上,旨在开发创新的治疗方法并显着改善患者的预后。
BACKGROUND: Parkinson\'s Disease (PD) is frequently associated with a spectrum of sleep-related disorders, including insomnia, Excessive Daytime Sleepiness (EDS), REM sleep Behaviour Disorder (RBD), Restless Legs Syndrome (RLS), and Sleep-related Breathing Disorders (SBDs). These disorders significantly impact PD patients\' Quality of Life (QoL) and present unique diagnostic and therapeutic challenges.
METHODS: This review has explored the intricate relationship between PD and sleep-related disorders, emphasizing their distinctive features and underlying neurobiological mechanisms. It aimed to consolidate current knowledge to optimize clinical management and improve patient care. The profound impact of these disorders on QoL has been evaluated, along with precise diagnostic methodologies. Additionally, various therapeutic strategies, including pharmacological treatments, nonpharmacological interventions, and device-aided therapies, have been examined.
RESULTS: Sleep-related disorders are prevalent among PD patients. Specifically, RBD exhibits a prevalence of 40-50%, often preceding the onset of motor symptoms, indicating its potential as an early marker of PD. Despite their significant impact on QoL, these non-motor symptoms are frequently under-recognized and inadequately managed in clinical practice. Pharmacological treatments, along with nonpharmacological interventions, like cognitive-behavioral therapy for insomnia and lifestyle modifications, have shown varied efficacy. Device-aided therapies have also demonstrated the potential to improve sleep-related disorders and overall non-motor symptom burden.
CONCLUSIONS: Effective management of sleep-related disorders in PD calls for personalized, comprehensive, and multimodal therapeutic approaches. This requires the collaborative efforts of neurologists, sleep specialists, psychiatrists, and other healthcare professionals. Future research should focus on the intricate relationship between PD and sleep disorders, aiming to develop innovative treatments and significantly improve patient outcomes.