Objective: The present meta-analysis aims to provide a reliable estimate of the prevalence and associated clinical and neuropsychiatric aspects of the most frequent sleep disorders (SDs) occurring in Parkinson’s disease (PD), like Rapid Eye Movement (REM) Sleep Behavior Disorder (RBD), Excessive Daytime Sleepiness (EDS), Obstructive Sleep Apnea (OSA), Restless Legs Syndrome (RLS) and insomnia.

Background: SDs are very common non-motor symptoms of PD but differences in methodological procedures across studies produced a wide variability about their prevalence. Moreover, cross-sectional studies exploring clinical, demographic and neuropsychiatric aspects associated with their occurrence in PD reported mixed results.

Method: A systematic literature search was performed up to November 2021 using PsycInfo, PubMed, and Scopus. We extracted from each study data about the number of PD patients with and without SDs and data about demographic, clinical and neuropsychiatric and behavioral variables.

Results: We included 204 articles as part of the meta-analysis. The pooled prevalence of RBD was 46% and its occurrence was related to advanced age, lower educational level, longer disease duration, higher levodopa doses, worse motor and neuropsychiatric conditions, lower functional autonomy and worse quality of life. 
As for EDS, pooled prevalence was 34% and its occurrence was associated with advanced age, lower education level, longer disease duration, altered motor and autonomic symptoms, higher levodopa doses, lower functional autonomy and more severe neuropsychiatric symptoms. Conversely, OSA was reported in 45% of PD patients and was associated with advanced age and more severe motor symptoms. The pooled prevalence of RLS was 21% and its occurrence was related to longer disease duration, altered motor and non-motor symptoms and poorer quality of life. Finally, insomnia was reported in 42% of PD patients and was related to longer disease duration, higher levodopa doses and more severe depressive symptoms.

Conclusion: SDs in PD differ in their prevalence rate and seem to be the consequences of distinguishable pathophysiological mechanisms. Taking into account their different clinical and functional impact in PD, we suggest to develop more effective strategies of identification and management considering timing, doses and possible adverse effects of PD-related medications.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-clinical-and-neuropsychiatric-aspects-of-sleep-disorders-in-parkinsons-disease-a-meta-analysis/