Excessive Daytime Sleepiness in Parkinson's Disease

Excessive daytime sleepiness (EDS) is one of the most common sleep abnormalities in patients with Parkinson's disease (PD), yet its multifactorial etiology complicates its treatment. This review summarized recent studies on the epidemiology, etiology, clinical implications, associated features, and evaluation of EDS in PD. The efficacy of pharmacologic and non-pharmacologic treatments for EDS in PD was also reviewed.English language articles indexed in PubMed and Cochrane databases and Chinese-language papers indexed in Wanfang and National Knowledge Infrastructure databases that were published between January 1987 and November 2017 were located using the following search terms: "sleepiness", "sleep and Parkinson's disease", and "Parkinson's disease and treatment".Original research articles and critical reviews related to EDS in PD were selected.EDS is a major health hazard and is associated with many motor and nonmotor symptoms of PD. Its causes are multifactorial. There are few specific guidelines for the treatment of EDS in PD. It is first necessary to identify and treat any possible factors causing EDS. Recent studies showed that some nonpharmacologic (i.e., cognitive behavioral therapy, light therapy, and repetitive transcranial magnetic stimulation) and pharmacologic (i.e., modafinil, methylphenidate, caffeine, istradefylline, sodium oxybate, and atomoxetine) treatments may be effective in treating EDS in PD.EDS is common in the PD population and can have an immensely negative impact on quality of life. Its causes are multifactorial, which complicates its treatment. Further investigations are required to determine the safety and efficacy of potential therapies and to develop novel treatment approaches for EDS in PD.帕金森病的日间嗜睡：临床意义和管理摘要目的：帕金森病（PD） 的日间嗜睡（EDS）是一种常见的睡眠障碍。因发病的多因素，而导致治疗的复杂性。在这篇综述，我们收集了最近PD的EDS相关的文献，对其流行病学、病因、临床意义、特征、评估方法及治疗进行总结。 数据来源：我们对1987年01月到2017年11月发表在PubMed上的英文文献和万方及中国知网上的中文文献进行收集，选用的关键词为： “睡眠”、“睡眠和帕金森病”、“帕金森病和治疗”。 研究选择：关于PD的EDS的原创研究文章和综述。 结果：EDS能严重影响健康，且与PD的许多运动和非运动症状密切相关。EDS的发病存在多因素。目前，PD的EDS的治疗缺少明确的指南。PD的EDS的管理首先需要明确并治疗可能导致EDS的相关因素。最近的研究显示一些非药物（认知行为治疗、光疗、重复经颅磁刺激）和药物（莫达非尼、哌醋甲酯、咖啡因、伊曲茶碱、羟丁酸钠、阿托西汀）治疗方法可能有效。 结论：将来的研究需要进一步评估治疗的安全性和有效性，并探索关于PD的 EDS的新型治疗方法。.