Parkinson's disease is a degenerative disorder affecting the central nervous system. It is associated with uncontrollable movements and slurred speech. People with this disease often experience sleep disorders. According to a 2003 review published in the International Journal of Clinical Practice, difficulty initiating and maintaining sleep is one of the most common complaints in these patients. Fortunately, certain drugs can safely and effectively improve sleep quality in patients with Parkinson's disease.
Dopaminergic Drugs
One therapeutic approach for sleep disorders in Parkinson's is to treat the underlying disease. The Parkinson's condition is associated with low levels of the chemical dopamine. Dopaminergic drugs, such as precursors or agonists, enhance dopamine and reduce movements. This reduction in Parkinsonian movements helps facilitate sleep.
Pramipexole is manufactured by Boehringer Ingelheim and sold under the trade name Mirapex. It's a dopamine agonist prescribed for Parkinson's disease. A 2006 report published in "Sleep Medicine" tested the effects of a nightly pramipexole dose in Parkinson's patients with REM behavior disorder. This condition is associated with excessive movements during rapid eye movement, or REM, sleep. Mirapex reduced the symptoms of Parkinson's in almost 90 percent of the patients. These positive changes were maintained, in some cases, for more than two years. The drug was well tolerated with few side effects observed.
Hypnotic Drugs
Another therapeutic strategy in Parkinson's disease is to treat the sleep disorder directly. Hypnotic drugs like benzodiazepines are often prescribed to treat sleep problems. These medications reduce anxiety and other related symptoms, thereby facilitating sleep.
Clonazepam is made by Roche pharmaceuticals and sold as Klonopin in the United States. It is a hypnotic drug from the benzodiazepine class used in the treatment of anxiety disorders. A 2003 study in Movement Disorders shows that it is also effective in improving REM behavior disorder in people with Parkinson's disease. Patients treated with Klonopin experienced less sleep-related hallucinations. Only minor adverse reactions to the drug were reported.
Stimulant Drugs
A final therapeutic approach in Parkinson's disease is to treat the consequences of having the condition. Most Parkinson's patients are receiving dopaminergic drugs, and these medications typically cause fatigue. This symptom is usually managed by prescribing stimulant drugs to enhance alertness.
Modafinil is synthesized by Cephalon, Inc. and sold using the trade name Provigil. It's a stimulant drug typically used for the sleep problems caused by narcolepsy, apnea and shift work. A 2010 investigation presented in Neuropsychiatric Disease and Treatment looked at the effects of modafinil in people with Parkinson's disease. Three weeks of Provigil taken twice a day improved Parkinson's and reduced sleepiness. The drug was considered safe to use, as negative reactions were minimal.
References
- "International Journal of Clinical Practice"; Sleep Disorders in Parkinson's Disease; A. Abdelgabar et al.; November 2003
- "Sleep Medicine"; Use of Pramipexole in REM Sleep Behavior Disorder: Results from a Case Series; M. H. Schmidt et al.; August 2006
- "Movement Disorders"; Visual Hallucinations as REM Sleep Behavior Disorders in Patients with Parkinson's Disease; T. Nomura et al.; July 2003
- "Neuropsychiatric Disease and Treatment"; Daytime Sleepiness in Elderly Parkinson's Disease Patients and Treatment with the Psychostimulant Modafinil: A Preliminary Study; J. Lokk; April 7, 2010
