Objective: to specify the clinical features of sleep disorders in patients with PD and their impact on quality of life indicators; assessment of the relationship between manifestations of insomnia and indicators of disease severity, assessment of the effect of ADR therapy with pramipexole on clinical symptoms associated with night sleep

Background: Nocturnal sleep disorders are common and clinically significant neuropsychic manifestations of Parkinson’s disease (PD). However, in more than half of the cases these disorders are not diagnosed, which is due, in particular,  to the underestimation of the degree of their negative impact on the quality of life of patients. As a result, patients do not receive adequate treatment for clinically significant symptoms of the disease. In addition, many of these drugs negatively affect the motor and intellectual functions of patients with PD.

Method: Fifty – nine  PD patients without dementia (mean age 61.2±9.3 years; mean PD duration 5.9±4.2 years) were followed up. Forty patients received pramipexole in a daily dose of 2.64±0.6 mg in addition to other dopaminergic agents. The unified the PD sleep scale (PDSS), the Beck depression inventory and PD fatigue scale (PFS-16) and the PD quality of life scale (PDQ-39) were used.

Results: Sleep fragmentation and early morning awakenings are the most common sleep disorders in PD. Pramipexole therapy resulted in a significant improvement in sleep quality, a reduction in the frequency of falling asleep and nocturnal awakenings. The improved characteristics of sleep were favored by a therapy-induced decrease in the severity of motor (hypokinesis, rigidity, tremor, nocturnal and morning dystonia) and nonmotor (restless legs syndrome/akathisia, sensory disorders, nocturia) PD manifestations.

Conclusion: The data obtained indicate the heterogeneous multifactorial nature of the pathogenesis of these disorders, as well as the presence of pathogenetic mechanisms common to other neuropsychiatric disorders. Clinical assessment of sleep disorders showed their dependence on the duration of PD, the severity of motor and non-motor symptoms (emotional, cognitive, sensory, urological). Our data on improved sleep quality due to a reduction in the severity of motor and non-motor symptoms while taking the ADR pramipexole may serve as an additional argument for prescribing this drug to patients with PD and insomnia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-disorders-in-parkinsons-disease/