Parkinson’s Disease Motor and Non-Motor Features Accompanying Insomnia and Excessive Daytime Sleepiness Symptoms, a Large Population-Based Study
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Sleep Disorders in the Elderly
Submission Deadline: September 15, 2020 (Open) Submit Now
Roy G. Beran, MD
Conjoint Professor, Department of Medicine, University of New South Wales, Sydney, Australia;
Professor, School of Medicine, Griffith University, Nathan, Queensland, Australia;
Professor, Chair, Medical Law, Sechenov Moscow First State University, Moscow, Russia
Research Interests: Sleep; health law & ethics; epilepsy; sleep disorders; drug trials; legal medicine; neurological conditions & new therapies; neurological advances
About This Topic
"Sleep Disorders in the Elderly" is a broad ranging topic that largely encompasses all of geriatric medicine as well as the neurology of the elderly. Those dealing with older patients are usually either geriatricians or neurologists, rather than sleep physicians. Almost no geriatricians and very few neurologists are cross-accredited with appropriate training in sleep medicine. As a consequence, this relegates consideration of sleep-related disorders to the periphery of patient evaluation, despite such conditions as obstructive sleep apnoea (OSA) having the potential to result in significant increase in stroke, myocardial infarction and dementia. Restless legs and Periodic Limb Movements In Sleep (PLMS), often with arousal (PLMA), respond to anti-Parkinsonian agents, such as dopamine agonists, such as Pramipexole, raising consideration that dopamine agonists have a therapeutic role in a number of sleep disorders.
As people age, so there is a comparable increase in sleep related disorders, such as OSA. With age often comes increased affluence, obesity and related issues of which OSA is just one of many. Degenerative diseases, such as Parkinson's Disease (PD), also increase in prevalence with advancing age. PD is associated with a number of sleep-related problems, including REM Behaviour Disorder (RBD) as well as OSA.
With the growing appreciation of the ubiquitous impact of sleep-related problems, particularly amongst the elderly, it has been appreciated that there is an unmet need to provide an educative resource to help those involved in the management of the elderly to enhance better management of their sleep disorders.
Because of the impact of Continuous Positive Air Pressure (CPAP) OSA, in many countries, such as Australia, has been usurped by respiratory physicians to the point that the Australian Health Practitioner Registration Agency/Authority does not cross-accredit either geriatricians or neurologists as sleep physicians and only categorises sleep medicine within the rubric of respiratory and sleep medicine, ignoring the fact that OSA was first diagnosed by neurologists when investigating patients thought to have epilepsy with all night video telemetric electroencephalography. It follows that there are a number of biases involved in the management and recognition of sleep medicine, which has greater relevance in the elderly, and it is envisaged that this focused issue of the Journal will address at least some of those unmet needs.
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