Anti-parkinsonian drugs and sleep disorders in Parkinson s disease

Abstract

Sleep disturbances are a frequent and relevant clinical phenomenon for the management of Parkinson's disease (PD). It is estimated that 60% to 90% of the patients with PD complain of difficulties associated with sleep and these disorders can be categorized into those that involve nocturnal sleep and daytime manifestations such as excessive daytime sleepiness. The causes of sleep disorders in PD are considered to be multifactorial: related to the disease itself, to co-morbidity or ageing, or even linked to the direct or indirect effects to the numerous drugs prescribed to these patients. All of the hypothesised factors have to be incorporated into the methodology of studies designed to approach this problem. This dissertation presents several research projects conducted to better understand the phenomenology of somnolence and other sleep disorders as adverse effects of antiparkinsonian drugs, and to contribute to their clinical management. The research projects cover different aspects of this topic and intentionally apply different study methodologies, from case reports (observational studies) to systematic reviews, including cross-sectional studies, clinical trials and other study designs.