A recent study involving 22 patients with Parkinson’s disease (PD) has provided new insights into how the dopaminergic drug levodopa affects sleep quality. The study found that when patients took levodopa, their sleep improved significantly.
Specifically, the number of times they woke up during the night decreased by 25%, and the total time they remained awake during the night dropped by 30% on average.
These findings were reported in the Journal of Sleep Research, where the researchers detailed their approach to monitoring the sleep-wake patterns of PD patients using a wearable actigraph, a device similar to a wristwatch that tracks movement.
Over four nights, the patients were observed—three nights while taking levodopa and one night without it.
Interestingly, while the actigraphic data showed clear improvements in sleep quality, the patients themselves did not report feeling any difference in their sleep when asked subjectively.
This disconnect between the objective measurements and the patients’ subjective experiences highlights a critical point for clinical care.
Dr. Fábio Barbieri, the study’s senior author, emphasized the importance of considering these objective findings when determining whether to prescribe levodopa to PD patients before bedtime.
Barbieri, who leads the Human Movement Research Laboratory (MOVI-LAB) and manages a project that provides physical activities for PD patients at UNESP’s Bauru campus, noted that PD can impair patients’ perceptions, making them less likely to notice improvements in their sleep, even when such improvements are objectively measurable.
Levodopa and similar dopaminergic drugs are commonly used to treat the motor symptoms of PD, such as tremors and shaking. The dopaminergic system, which these drugs target, is also involved in regulating sleep.
Changes in dopamine levels naturally occur as the brain cycles through different stages of sleep and wakefulness.
While levodopa appears to help improve sleep by reducing the time it takes for PD patients to fall asleep and by decreasing nighttime awakenings, there are also potential risks.
Some patients may experience sleep disturbances as a side effect of the medication, along with other possible side effects like confusion, drowsiness, insomnia, nightmares, hallucinations, and agitation. This underscores the importance of using the drug only under a physician’s guidance.
Dr. Barbieri pointed out that sleep disturbances are very common among PD patients, with about 90% experiencing issues like insomnia, daytime drowsiness, and restless leg syndrome.
Improving sleep quality is particularly important for these patients, as better sleep has been linked to improved mobility and cognitive function, especially in the early morning.
For this reason, Barbieri and his team stressed the value of using objective tools like actigraphy to assess the true impact of medications like levodopa on sleep. According to their findings, skipping the evening dose of levodopa led to worse outcomes in terms of sleep quality.
Sleep quality in PD patients is not just a matter of rest; it also affects mobility. Poor sleep has been associated with freezing of gait, a condition where patients suddenly become unable to start or continue walking, often leading to falls. This symptom is one of the most debilitating for PD patients.
In addition to the study on sleep, Barbieri’s team has conducted other research using artificial intelligence to analyze gait patterns in PD patients.
By assessing parameters such as step length, width, velocity, and consistency, they aim to improve clinical diagnosis and track the progression of the disease more accurately.
The data from these studies is available online for other researchers to use, contributing to the broader understanding of how PD affects both sleep and mobility.
This research highlights the complex relationship between medication, sleep, and mobility in Parkinson’s disease, and underscores the importance of using objective measures to guide treatment decisions.
While patients may not always perceive improvements in their sleep, tools like actigraphy can provide valuable insights that help clinicians optimize care and improve the quality of life for those living with PD.
If you care about Parkinson’s disease, please read studies that Vitamin B may slow down cognitive decline, and Mediterranean diet could help lower risk of Parkinson’s.
For more information about brain health, please see recent studies that blueberry supplements may prevent cognitive decline, and results showing Plant-based diets could protect cognitive health from air pollution.
The research findings can be found in the Journal of Sleep Research.
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