Progression of Sleep Disturbances in Early Parkinson’s Disease

Sarfaroj Khan 

August 21, 2020


  • The frequency of insomnia, excessive daytime sleepiness (EDS), and probable rapid eye movement sleep behaviour disorder (pRBD) all increase over time in early Parkinson’s disease (PD), with insomnia frequency increasing most rapidly.

Why this matters

  • Sleep disorders can occur in early PD. However, the association between different sleep disturbances and their longitudinal evolution has not been fully explored.

Study design

  • This 5-year longitudinal study included 218 patients with PD and 102 control participants from the Parkinson’s Progression Markers Initiative (PPMI) database.

  • Longitudinal progression of three common sleep disturbances (EDS, insomnia, and pRBD) and their interactions in early PD were evaluated.

  • Funding: None disclosed.

Key results

  • At 5 years:

    • 85 (39.0%) patients with PD reported one type of sleep disturbance: 42 (19%) reported insomnia only, 24 (11.0%) reported pRBD only and 19 (8.7%) reported EDS only.

    • 51 (23.4%) patients reported two types of sleep disturbances: 23 (10.6%) reported insomnia and EDS, 16 (7.3%) reported insomnia and pRBD, and 12 (5.5%) reported pRBD and EDS.

    • 16 (7.3%) reported all three types of sleep disturbances.

  • Patients using sleep medications increased from 16 (7.3%) at baseline to 41 (18.8%) after 5 years.

  • At 5-year follow-up, the largest increase in frequency was observed in insomnia (44.5%), followed by EDS (32.1%) and pRBD (31.2%).

  • Insomnia was the most common sleep problem reported at any time during the 5-year follow-up, followed by pRBD and EDS.

  • In contrast, the frequency of sleep disturbances in control participants remained stable over the 5-year follow-up.


  • Real frequency of sleep symptoms and other undiagnosed primary sleep disorders could be underestimated in the absence of polysomnography.


Xu Z, Anderson KN, Saffari SE, Lawson RA, Chaudhuri KR, Brooks D, Pavese N. Progression of sleep disturbances in Parkinson's disease: a 5-year longitudinal study. J Neurol. 2020 Aug 17 [Epub ahead of print]. doi: 10.1007/s00415-020-10140-x. PMID: 32804280.  View abstract.

This clinical summary first appeared on Univadis, part of the Medscape Professional Network.


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