ABSTRACT
INTRODUCTION The earliest description of sleep problems of Parkinson’s disease (PD) dates back to the original description of PD by James Parkinson. In his original monograph, he stated that “His attendants observed, that of late the trembling would sometimes begin in his sleep, and increase until it awakened him: when he always was in a state of agitation and alarm” (1). This may have been the first description of nocturnal akinesia, tremor and, perhaps, rapid eye movement (REM) behavior disorder (RBD) that complicate sleep of people with PD. In spite of sleep dysfunction being a key aspect of the nonmotor symptom complex of PD, it is only recently that sleep disturbances related to PD have received diagnostic and therapeutic attention (2-8). The issue of sleep dysfunction and its treatment has also become relevant, as evidence suggests that sleep problems are a key determinant of quality of life and effective treatment may improve overall quality of life (9,10). “Poor nights” for people with PD may occur not only in advanced PD, but also in early untreated PD or even prior to motor symptoms. Such morbidity may have a significant adverse effect on daytime functioning and functional capacity (such as driving), as well as quality of life (9-12). Certain sleep disorders may provide useful diagnostic information in differentiating between parkinsonian syndromes and may be important prognostic indicators of neuropsychiatric disturbance and dementia (13).
