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Practical Evaluation and Management of Insomnia in Parkinson's Disease: A Review
Author(s) -
Wallace Douglas M.,
Wohlgemuth William K.,
Trotti Lynn Marie,
Amara Amy W.,
Malaty Irene A.,
Factor Stewart A.,
Nallu Sagarika,
Wittine Lara,
Hauser Robert A.
Publication year - 2020
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.12899
Subject(s) - insomnia , expert opinion , parkinson's disease , medicine , disease , pharmacotherapy , intensive care medicine , psychiatry
Background Insomnia is one of the most common nonmotor features of Parkinson's disease (PD). However, there are few practical guidelines for providers on how to best evaluate and treat this problem. Methods and Findings This review was developed to provide clinicians with a pragmatic approach to assessing and managing insomnia in PD. Recommendations were based on literature review and expert opinion. We addressed the following topics in this review: prevalence of insomnia in PD, sleep–wake mechanisms, theoretical models of insomnia, risk factors, assessment, pharmacologic and nonpharmacologic treatments. Insomnia treatment choices may be guided by PD severity, comorbidities, and patient preference. However, there is limited evidence supporting pharmacotherapy and nonpharmacologic treatments of insomnia in PD. Conclusions We provide a pragmatic algorithm for evaluating and treating insomnia in PD based on the literature and our clinical experience. We propose personalized insomnia treatment approaches based on age and other issues. Gaps in the existing literature and future directions in the treatment of insomnia in PD are also highlighted.