Parkinson’s non-motor symptoms of sleep disorders

  Sleep disorders are present in at least 60-90% of people with Parkinson’s disease and can have a significant impact on the quality of life of patients.  Common sleep disorders in patients with Parkinson’s disease include insomnia, sleep fragmentation, REM behavior disorder (RBD), excessive daytime sleepiness (EDS) or sleep episodes, and abnormal sleep breathing. Among them, REM behavior disorder (RBD) is most closely related to Parkinson’s disease, and many studies have shown that RBD can appear more than 10 years before the onset of Parkinson’s disease, so it can be regarded as the precursor manifestation of Parkinson’s disease, which is important for the diagnosis and early prediction of Parkinson’s disease. In addition, the occurrence of RBD can also predict the rapid progression of Parkinson’s disease, cognitive impairment, and the appearance of psychiatric symptoms, which is important for Parkinson’s disease research.  So what is RBD?  RBD is an episodic disorder characterized by the loss of muscle relaxation during REM sleep and the appearance of complex movements associated with dreams, which can lead to self-injury and bed partner injuries and interrupted sleep. Patients often put their nightmares into action by chewing, shouting, whispering, talking to others, laughing, crying, cursing or singing, or in severe cases, punching, kicking, knocking over bedside tables, sitting up from bed, or even jumping or rolling out of bed, injuring themselves or their co-sleepers. Some patients may also have certain non-violent behaviors, such as whistling, making strange faces, or making certain actions that seem to have a purpose. Patients with RBD are often awakened quickly and can recall vivid, unpleasant, or frighteningly violent dreams.  In addition to the previously mentioned RBD, patients with Parkinson’s disease can also have other sleep problems, the more common being excessive daytime sleepiness (EDS).  It is often said that spring sleepiness, autumn sleepiness, summer snooze, and sleepless winter March seem to make daytime sleepiness possible all year round. In fact, always want to sleep during the day, may also be a disease, the key is whether there is “excessive” drowsiness phenomenon. If a person sleeps enough at night, without the influence of drugs, and without metabolic or endocrine problems, and still wants to sleep too much during the day, then it may be excessive daytime sleepiness. In the case of excessive daytime sleepiness, a mild case is just a mental trance, lack of concentration, and work can still be carried out as usual; in the case of moderate cases, it is easy to fall asleep when the mind is relaxed, such as after eating, watching TV or listening to music. Severe cases are more troublesome, and they can fall asleep uncontrollably on occasions when they must pay full attention, such as driving, meeting with important clients, eating, etc. This can often lead to more serious consequences and even danger. Of course, excessive daytime sleepiness is only a clinical symptom, and common clinical disorders include sleep apnea syndrome, episodic sleeping sickness, and nocturnal muscle contracture. The specific needs to be examined by clinicians, combined with sleep monitoring, considering central nervous, metabolic, endocrine and other issues, to make a judgment after the synthesis. Therefore, if excessive daytime sleepiness occurs, it is recommended to pay attention to it and seek medical attention early.