Conclusion

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Sleep disorders in patients with PD are common (94). They are a key component of the nonmotor symptom complex of PD and remain under-diagnosed and under-treated. Sleep problems may arise from uncontrolled motor symptoms, degeneration of the neuroanatomical substrates responsible for the sleep-wake cycle or unwanted medication side effects. Routine assessment of patients with PD should include inquiry regarding the quality of sleep and sleep-related symptoms. Use of validated bedside clinical tools such as the PDSS, SCOPA-Sleep, and ESS offer a robust way to assess the presence or absence of sleep disruption. Uncontrolled nocturnal motor symptoms may be ameliorated by long-acting dopaminergic agents, whereas other sleep disruptions such as hallucinations or RBD require a different approach. In resistant cases, patients may need to undergo a formal sleep study with PSG and/or MSLT. Targeted nighttime treatment should result in improved sleep for patients with PD.

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