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Practical Evaluation and Management of Insomnia in Parkinson's Disease: A Review.


ABSTRACT: Insomnia is one of the most common nonmotor features of Parkinson's disease (PD). However, there are few practical guidelines for providers on how to best evaluate and treat this problem. This review was developed to provide clinicians with a pragmatic approach to assessing and managing insomnia in PD. Recommendations were based on literature review and expert opinion. We addressed the following topics in this review: prevalence of insomnia in PD, sleep-wake mechanisms, theoretical models of insomnia, risk factors, assessment, pharmacologic and nonpharmacologic treatments. Insomnia treatment choices may be guided by PD severity, comorbidities, and patient preference. However, there is limited evidence supporting pharmacotherapy and nonpharmacologic treatments of insomnia in PD. We provide a pragmatic algorithm for evaluating and treating insomnia in PD based on the literature and our clinical experience. We propose personalized insomnia treatment approaches based on age and other issues. Gaps in the existing literature and future directions in the treatment of insomnia in PD are also highlighted.

SUBMITTER: Wallace DM 

PROVIDER: S-EPMC7111581 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Practical Evaluation and Management of Insomnia in Parkinson's Disease: A Review.

Wallace Douglas M DM   Wohlgemuth William K WK   Trotti Lynn Marie LM   Amara Amy W AW   Malaty Irene A IA   Factor Stewart A SA   Nallu Sagarika S   Wittine Lara L   Hauser Robert A RA  

Movement disorders clinical practice 20200203 3


<h4>Background</h4>Insomnia is one of the most common nonmotor features of Parkinson's disease (PD). However, there are few practical guidelines for providers on how to best evaluate and treat this problem.<h4>Methods and findings</h4>This review was developed to provide clinicians with a pragmatic approach to assessing and managing insomnia in PD. Recommendations were based on literature review and expert opinion. We addressed the following topics in this review: prevalence of insomnia in PD, s  ...[more]

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