Parkinson’s disease is not just “shaking”, multiple sleep disorders need attention

Parkinson’s disease is not just “shaking”, multiple sleep disorders need attention

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Parkinson’s disease is a neurodegenerative disease whose main clinical manifestations are motor symptoms such as resting tremor, myotonia, and slow movement, and non-motor symptoms such as sleep disorders, olfactory disorders, autonomic nervous system dysfunction, cognitive and mental disorders, etc. . Experts remind that non-motor symptoms may exist before the appearance of motor symptoms in patients with Parkinson’s disease, and can occur throughout the entire course of the disease. Once discovered, active and reasonable intervention can help improve the patient’s quality of life.

12 Non-Motor Symptoms to Know

Uncle Lu (pseudonym), who is in his 70s, started to suffer from stiffness and inflexibility in the movement of his right upper limb a few years ago. Later, it gradually spread to his right lower limb, and progressed to stiffness on both sides of the limbs. His movements were significantly slowed down, and he had difficulty sleeping and even turning over at night. According to family reports, Uncle Lu would sometimes yell, punch and kick in his sleep, his temper would change, he would be irritable and suspicious, and sometimes he would hallucinate and hit and curse others. The family found that when chatting during the day, he would suddenly fall asleep or even start snoring. What’s the matter?

Accompanied by his family members, Uncle Lu went to the Neurology Department of the Second Affiliated Hospital of Guangzhou Medical University for medical treatment and was diagnosed with Parkinson’s disease. According to Professor Liu Jun, director of the Department of Neurology of the hospital, in recent years, non-motor symptoms of Parkinson’s disease have gradually attracted people’s attention. The following 12 common symptoms are: 1. Mild cognitive impairment; 2. Dementia; 3. Depression; 4. Anxiety; 5. Apathy; 6. Psychotic symptoms and delirium; 7. Sleep disorders; 8. Autonomic nervous system dysfunction; 9 Sensory disorders; 10. Fatigue; 11. Impulse control disorder and dopamine dysfunction syndrome; 12. Language dysfunction.

Non-motor symptoms may exist to varying degrees before the onset of motor symptoms in patients with Parkinson’s disease, and may occur throughout the course of the disease. However, Yang Shaoqing, chief physician of the Department of Neurology of the hospital, reminded: Non-motor symptoms are not unique to Parkinson’s disease. Even if there is a loss of smell or sleep disorder, Parkinson’s disease cannot be diagnosed. Therefore, you cannot diagnose or doubt whether you have Parkinson’s disease based on the above 12 non-motor symptoms. The diagnostic criteria of the International Parkinson and Movement Disorders Association are: 1. Bradykinesia; 2. Resting tremor; 3. Myotonia. Among them, item 1 is necessary, and one of items 2 and 3 can be clinically diagnosed as Parkinson’s disease.

Sleep disorders manifest in various ways

Experts from the Parkinson’s disease diagnosis and treatment team of the Second Hospital of Guangzhou Medical University pointed out that sleep disorders are one of the most common non-motor symptoms in patients with Parkinson’s disease. Clinically, more and more patients with Parkinson’s disease, like Uncle Lu, are going to neurology departments because of sleep disorders. According to the main manifestations of patients, they can be divided into the following categories:

REM sleep behavior disorder: Patients lose body muscle tone during REM sleep, causing thoughts in dreams to be expressed in the form of actions. For example, Uncle Lu sometimes yells, punches, kicks and other actions in his sleep.

Daytime sleepiness and sleep attacks: falling asleep suddenly during a conversation and waking up naturally after 10-20 minutes.

Insomnia: manifested by difficulty falling asleep, frequent awakenings and early awakenings.

Restless Legs Syndrome: Unbearable discomfort in the legs that occurs repeatedly during rest at night, is relieved or disappears after activity, but may recur after stopping, making the patient unbearable.

Sleep breathing disorder: Typical symptoms include snoring, apnea, and hypopnea during sleep.

Sleep disorders seriously affect the quality of life of patients with Parkinson’s disease and their families. After asking about the medical history and understanding the patient’s medication status, clinicians can also use polysomnography to help diagnose when necessary, so as to formulate more targeted treatment plans.

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