Introduction
Sleep is a complex neurological state that facilitates the restoration and renewal of energy levels. Around one-third of a person's life is spent sleeping, and extensive research has shown that disruptions in sleep hurt one's well-being. Insufficient sleep length and low sleep quality hurt both the individual's general welfare and physical health, as well as leading to adverse social and economic consequences. To provide optimal care, it may be required to address sleep disruptions that occur due to chronic illnesses in addition to treating the underlying ailment. Insomnia is common among patients with Parkinson's disease (PD) and has a substantial effect on their quality of life.
What Is Parkinson’s Disease?
Parkinson's disease is a neurodegenerative disorder characterized by the progressive loss of dopamine-producing cells in the brain, leading to motor and non-motor symptoms such as tremors, rigidity, and impaired balance and coordination. It is a neurological ailment that mostly affects the motor system and is believed to impact approximately one million individuals in the United States. The production of dopamine in brain cells is significantly diminished. This condition impacts the central nervous system, leading to excessive mobility and tremors in the muscles.
Parkinson's disease is not considered to be a hereditary ailment, as only 15 percent of cases have reported a familial history of the disease. Due to its impact on the muscles, the condition can have negative consequences for both physical mobility and emotional well-being. Current study is centered around the increased prevalence of sleep disturbances in individuals diagnosed with Parkinson's disease.
What Are the Reasons Behind the Sleep Difficulties Experienced by Individuals With Parkinson’s Disease?
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Parkinson's disease and the drugs used for its treatment can cause various sleep disturbances, resulting in insomnia (sleeplessness) and excessive drowsiness or tiredness during the day.
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Individuals with difficulties with mobility or movement may have difficulty adjusting their sleeping positions to attain comfort. Some people may experience disturbing hallucinations or illusion as they fall asleep. These symptoms may result from drug use or memory loss.
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Consequently, excessive daytime sleepiness (EDS) may arise due to inadequate sleep during the night. Additionally, it might be provoked by drugs. Individuals with Parkinson's disease who have excessive daytime sleepiness (EDS) may face an increased likelihood of accidents and may be unable to perform tasks such as driving a vehicle safely.
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The common co-occurrence of sleeplessness with anxiety and despair. It could potentially be a causative element in sleep disturbances in those diagnosed with Parkinson's disease.
What Are the Sleep Disorders Associated With Parkinson’s Disease?
Individuals with Parkinson's disease exhibit a heightened vulnerability to specific sleep disorders, in addition to other sleep-related issues such as the following:
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Circadian Rhythm Disruptions: Decreased dopamine (regulates memory, emotion, sleep, learning, attention, mobility, and various other bodily activities) levels can have a substantial impact on the body's sleep-wake cycle. This disturbance of the circadian cycle might affect their sleep pattern, leading to insomnia and excessive daytime sleepiness.
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REM Sleep: REM sleep behavior disorder, affects up to 50 percent of individuals with Parkinson's disease, is a prevalent sleep problem. The REM sleep behavior disorder is characterized by individuals unconsciously acting out their dreams. Their physical gestures may manifest as aggressive behavior, such as awakening a sleeping companion. Contrary to sleepwalking, individuals with REM sleep behavior disorder typically retain memories of their dreams and characterize them with high detail. The onset of REM sleep behavior disorder typically occurs several years prior to the diagnosis of Parkinson's disease and seems to be associated with a higher likelihood of experiencing more pronounced memory deterioration.
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Obstructive Sleep Apnea: Obstructive sleep apnea, or OSA, is a condition in which individuals have frequent interruptions in their breathing during sleep, leading to a decrease in the quality of their sleep. This is often accompanied by snoring and experiencing sudden and sharp inhalation of breath. Individuals affected with Parkinson's disease frequently exhibit upper airway blockage, restrictive lung disease, and other variables that increase the likelihood of developing obstructive sleep apnea (OSA).
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Restless Legs Syndrome: Restless legs syndrome, or RLS, is a condition where there is a strong and uncontrollable need to move the legs, particularly when the body is not in motion. Most of the individuals with Parkinson's disease are affected by this sleep problem, which frequently manifests in the early stages of the condition. There is a potential connection between the simultaneous presence of Parkinson's disease and restless legs syndrome, which may be attributed to a deficiency of dopamine in the body.
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Nocturia: Nocturia refers to the condition of frequently waking up during the night to urinate. The condition of frequent urination during the night, known as nocturia, impacts a significant majority of individuals. Frequent nighttime urination can reduce the quality of sleep and result in less restorative sleep, even though it is not considered a sleep disorder.
What Is the Treatment Approach for Sleep Disorders in Individuals Diagnosed With Parkinson’s Disease?
The healthcare professional will suggest treatments that target the underlying causes of sleep difficulties. The service provider has the ability to:
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Modify Medicine: If a certain medication is potentially responsible for the sleep problems, healthcare professionals may opt to alter the treatment regimen. Modifying the dosage or substituting medications may resolve the issue.
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Therapeutic Intervention: The healthcare professional will initiate the available alternatives after suggesting an innovative pharmaceutical or therapeutic intervention for the individual, who is suspected of having a sleep disorder. An alternative medication may be recommended by the healthcare professional on occasion. Individuals who have this condition may benefit from using a specialized oral appliance. By provisioning an uninterrupted flow of oxygen, the apparatus averts respiratory distress in the body.
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Lifestyle Modifications: Everyday routines and sleeping conditions might either support or hinder sleep endeavors. Establishing consistent sleep and wake schedules, maintaining a dark sleeping environment, and refraining from using electronic devices before bedtime will enhance the quality of sleep. If patients are diagnosed with REM sleep disorder, healthcare professionals will engage in a conversation about various strategies to ensure the safety and the safety of others throughout sleep.
Conclusion
Sleep disturbances are the primary factors contributing to illness among the nonmotor symptoms of PD. Some of the reasons for excessive daytime sleepiness (EDS) may be attributed to motor impairment or disease-related factors, which could potentially improve with optimal treatment of PD. Among the early signs of Parkinson's disease, sleep disorders such as REM sleep behavior disorder (RBD) and insomnia related to depression are frequently observed. Nevertheless, Restless Leg Syndrome (RLS) may be linked to a heightened likelihood of acquiring Parkinson's Disease (PD) in the future. On the other hand, Rapid Eye Movement Sleep Behavior Disorder (RBD) has been established as a reliable indicator of the onset of clinical PD and other neurodegenerative disorders. Further research is necessary to provide guidance for the treatment of these particular sleep disturbances in PD. Currently, the treatment is derived by extrapolating data from studies conducted on individuals without PD. Various factors may contribute to sleep disturbances in a particular patient, and tailoring treatment options to the individual may enhance the overall well-being of individuals with Parkinson's disease.
