An informative and practical overview of sleep problems among patients with neurodegenerative disorders

The coexistence of neurodegenerative diseases and sleep disorders is increasingly being recognized. While there is considerable evidence to suggest that such conditions are inherent to the neurodegenerative process, most seem to occur in the context of numerous intrinsic and extrinsic variables, as exemplified by the fact that medications used for therapeutic purposes can themselves result in deleterious sleep effects. Primary sleep disorders such as obstructive sleep apnea and restless legs syndrome increase in prevalence with age, and can result in unique clinical scenarios and diagnostic challenges when combined with neurodegenerative diseases. Rapid-eye-movement sleep behavior disorder is of particular interest, as it appears to exhibit a predilection for specific neurodegenerative entities, and may therefore have diagnostic utility. Identification of all factors impacting sleep disturbances is important, as sleep complaints significantly influence the rate of institutionalization in the elderly. This article highlights various pathophysiologic and clinical investigations concerning sleep findings in neurodegenerative diseases, focusing particularly on those most commonly seen by practitioners.