Study Shows Multiple Sleep Problems Are Common in Early Parkinson's
More than 75% of people with Parkinson’s disease (PD) report sleep-related symptoms. The presence of sleep disorders can significantly impact quality of life for the person with Parkinson’s and their care partner, contributing to fatigue, cognitive impairment and mood disorders.
Sleep disorders can manifest in various ways, including insomnia (difficulty falling asleep or staying asleep), Rapid eye movement (REM) sleep behavior disorder (acting out dreams), restless leg syndrome, excessive daytime sleepiness and sleep apnea.
Research shows that sleep problems are common in early Parkinson’s stages and can get worse as the disease progresses. It’s likely that these issues stem from a combination of factors including the disease's impact on brain regions regulating sleep-wake cycles. Research also shows that sleep issues are worsened due to coexisting PD conditions like depression and anxiety, medication side effects and movement symptoms.
However, it remains unclear if people with PD usually suffer from one single type of sleep problem, or from multiple sleep problems at the same time. In addition, researchers are still learning how sleep issues relate to other aspects of PD. A new study published in npj Parkinson's Disease systematically evaluated sleep issues in people with early-stage Parkinson's.
Study Results
To learn more about sleep disorders, the study examined sleep issues in 162 people with early-stage Parkinson's and 58 people without the disease. The research team used interviews, overnight sleep studies (polysomnography) and various tests to understand the participants' sleep, motor skills, thinking abilities and other health factors.
They found that a large majority (71%) of those with early-stage Parkinson's had at least one sleep disorder. Importantly, about half of those with sleep problems experienced multiple issues at the same time. They also observed that the longer someone had Parkinson's and the more problems they had with involuntary bodily functions (like blood pressure or digestion), the more sleep disorders they tended to have.
This new study data shows that most common sleep issues associated with Parkinson’s were insomnia (41% of participants), followed by REM sleep behavior disorder and excessive daytime sleepiness (both 25% of participants), and restless legs syndrome (16% of participants). Rates of sleep-disordered breathing, such as sleep apnea, were consistent between those with and without the disease.
The researchers looked for trends between sleep disorders, demographics, and common PD symptoms. They found that insomnia, especially trouble staying asleep, was more common in women and those with restless legs syndrome but wasn't linked to movement problems or mood issues. REM sleep behavior disorder seemed to be connected to problems with involuntary bodily functions (like blood pressure or digestion) and older age, but not movement or thinking difficulties. Excessive daytime sleepiness was related to mood symptoms, movement problems and the use of certain Parkinson's medications, but not other sleep disorders.
Overall, the study found that sleep problems are very common even in early-stage Parkinson's and that people with PD often suffer from multiple sleep issues at the same time. The results suggest that these sleep issues are more likely to be tied to physical changes in the body rather than psychological factors, like anxiety or depression.
Highlights
-
The study enrolled 162 people with early-stage Parkinson's and 58 people without the disease.
-
The study found that sleep problems are very common in early Parkinson's and that many PD patients have multiple sleep disturbances.
-
The most common sleep problems impacting people with Parkinson’s were insomnia (41% of participants), REM sleep behavior disorder (25% of participants), excessive daytime sleepiness (25% of participants), and restless legs syndrome (16% of participants).
-
Sleep issues are more likely tied to physical changes in the body rather than psychological factors, like anxiety or depression.
What does this mean?
Sleep disorders are a common non-movement symptom in Parkinson’s disease, and are typically caused by changes in the body, rather than by anxiety or depression. Importantly, this study shows that people with PD frequently experience multiple sleep disorders at once. This increases the difficulty of properly treating sleep disorders and likely increases the burden of sleep issues on the daily lives of those with PD.
Additionally, this study reflects that many people in the early stages of PD — even before the development of severe motor impairment — experience sleep issues. Thrashing around in bed or acting out dreams when deeply asleep may be an early sign of Parkinson's.
What do these findings mean to the people with PD right now?
There are many tips you can try at home to naturally address sleep issues. There are also treatments your care team can recommend addressing sleep disorders. This is a topic everyone with PD should bring up to their doctor and care team, who may refer you to a sleep specialist. A specialist can evaluate and identify sleep issues, which can customize treatment options.
Sleep is particularly essential to people with PD as recent research studies have shown that sleep helps clear waste products from the brain. This has significant implications for people with PD as abnormal proteins build up in the brain.
Learn More
The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and sleep in our below resources, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions.
-
Sleep: A Mind Guide to Parkinson's Disease (Educational Guide)
