Sleep-wake and circadian disturbances in Parkinson disease: a short clinical guide

Sleep-wake and circadian disturbances are very frequent and often troublesome symptoms in patients suffering from Parkinson disease. Therefore, a concept for the evaluation and therapy of such disturbances must be considered and implemented by all physicians involved in Parkinson care. The present review shall offer a short and condensed guide for the clinician. It summarizes the epidemiology of sleep-wake and circadian disturbances in Parkinson disease, sheds some light into translational studies forwarding knowledge about underlying pathophysiological concepts, and discusses diagnostic approaches and current therapeutic recommendations, albeit the latter being mostly based on insufficient evidence. As most treatments for Parkinson-related sleep-wake disturbances are still off-label, we need more prospective randomized trials for being able to optimize and personalize treatment for every single patient.