ABSTRACT
Sleep disturbances are common in neurodegenerative diseases. Disturbed sleep can result
in fatigue, irritability, morning headaches, impaired motor and cognitive skills,
depression, and daytime somnolence. The major sleep complaints include insomnia, hypersomnia,
parasomnia, excessive nocturnal motor activity, circadian sleep–wake rhythm disturbance,
and respiratory dysrhythmia. The pathogenetic mechanisms of sleep disturbances may
be secondary to direct structural alteration of the sleep–wake generating neurons
or from several other indirect mechanisms. At the biochemical level, neurodegenerative
diseases may be largely classified as tauopathies, α-synucleinopathies, and other
diseases. Overnight polysomnography (PSG), Multiple Sleep Latency Test, Maintenance
of Wakefulness Test, and actigraphy are some important diagnostic laboratory tests
in the evaluation of sleep disturbances. Management of sleep disturbances is complex
and is based primarily on the nature of the sleep disturbance. The clinical profiles,
pathogenetic mechanisms, PSG findings, and management issues are discussed here with
reference to some common neurodegenerative diseases.
KEYWORDS
Neurodegenerative disease - sleep disturbance - polysomnography (PSG) - molecular
neurobiology
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