Abstract

A good night’s sleep is essential to a good quality of life. It is particularly relevant to patients with Parkinson disease (PD) because sleep can have a positive, although transient, effect on symptoms that exceeds that seen with the use of levodopa dosing (i.e., “sleep benefit”). Unfortunately, all too often PD patients spend their nights in misery. It may be difficult for some of them to turn or get out of bed, and many awaken frequently to urinate. Others may drool excessively, experience leg restlessness or pains, and still others are bothered frequently by disturbing nightmares. Some patients spend hours walking around or sitting in a chair, and caregivers describe episodes of nocturnal confusion. These symptoms are incapacitating by themselves, but because a bad night is often followed by a worse day characterized by intense fatigue and motor disability, they appear to have a profound negative impact on the disease and its …

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