Main sleep disorders in parkinsonian syndromes

Sleep disorders are frequent in patients with Parkinson's disease (PD) and parkinsonian syndroms. About 30% of the patients with PD complain of excessive daytime sleepiness, 15 to 59% develop REM sleep behavior disorders (RBD) and 60% report insomnia. In patients with multiple system atrophy (MSA) and dementia with Lewy bodies, these disorders are even more frequent. Almost all patients develop RBD, and half of them complain about insomnia. In MSA, 25% of the patients complain about excessive daytime sleepiness. Patients with MSA may also present a disabling sleep disordered breathing that reduces their life expectancy namely stridor. In cortico basal degeneration and progressive supra nuclear palsy, insomnia and excessive daytime sleepiness are also frequent but RBD are rare since this sleep disorder seems to be preferentially associated with synucleinopathies and rarely associated with tauopathies.