Assuntos
Terapia por Acupuntura , Doença de Parkinson , Transtorno do Comportamento do Sono REM , Terapia por Acupuntura/efeitos adversos , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/terapia , Transtorno do Comportamento do Sono REM/etiologia , Transtorno do Comportamento do Sono REM/terapiaRESUMO
Insomnia, hypersomnia and REM Sleep Behavior Disorder (RSBD) during sleep are major problems for patients suffering from Parkinson's disease (PD) but they are also used to predict its onset. While these secondary symptoms detract from the quality of life in PD patients, few treatment options are available due to limited efficacy or risk of complicating the treatment regimen. Light therapy (LT) has been suggested as a strategy for sleep disorders but it has only been implemented recently for use in PD. An open label, retrospective study was undertaken where PD patients had been undergoing LT, using polychromatic light, for four months to 15 years prior. It was found that 1 h exposure to light, just prior to retiring, significantly improved insomnia and reduced RSBD in as little as one month after commencing LT. In addition, the improvement was maintained as long as LT was continued over a four to six year period. The efficacy of LT in alleviating these sleep related conditions was not compromised by time since diagnosis or age of the patient. These results intimate the value of long term application of non-invasive techniques such as LT for treating sleep disorders in PD and justify further controlled trials on the long term efficacy of LT.
Assuntos
Doença de Parkinson/complicações , Fototerapia/métodos , Transtorno do Comportamento do Sono REM/terapia , Distúrbios do Início e da Manutenção do Sono/terapia , Idoso , Distúrbios do Sono por Sonolência Excessiva/terapia , Feminino , Humanos , Estudos Longitudinais , Masculino , Qualidade de Vida , Estudos RetrospectivosRESUMO
Sleep disturbances are among the most commonly endorsed symptoms of post-traumatic stress disorder (PTSD). Treatment modalities that are effective for the waking symptoms of PTSD may have limited efficacy for post-traumatic sleep problems. The aim of this review is to summarize the evidence for empirically supported and/or utilized psychotherapeutic and pharmacological treatments for post-traumatic nightmares and insomnia. While there are few controlled studies of the applicability of general sleep-focused interventions to the management of the sleep disturbances in PTSD, evidence is growing to support several psychotherapeutic and pharmacological treatments. Future investigations should include trials that combine treatments focused on sleep with treatments effective in managing the waking symptoms of PTSD.