How are sleep disturbances treated in patients with Parkinson disease (PD)?

Updated: Jan 24, 2019
  • Author: Robert A Hauser, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Benzodiazepines can be helpful in the treatment of rapid eye movement (REM) sleep behavior disorder (RBD), and obstructive sleep apnea (OSA) can be treated with positive airway pressure with either continuous pressure or bilevel pressure. Sleep hygiene techniques include avoiding stimulants/fluids near bedtime, avoiding heavy late-night meals, and following a regular sleep schedule. [112, 117] It is advised that patients with Parkinson disease and sudden-onset sleep avoid driving and take precautions against potential occupational hazards. [23]

The 2010 AAN practice parameter found insufficient evidence to support or refute beneficial effects from the treatment of RBD in Parkinson disease. Other sleep disorders may benefit from treatment. Levodopa/carbidopa should be considered to treat periodic limb movements of sleep. Modafinil may improve patients’ subjective perceptions of excessive daytime somnolence (EDS), and methylphenidate may be considered in patients with fatigue. [48]


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