Insomnia in patients with neurodegenerative conditions.

Comorbid insomnia and other sleep disturbances are common in patients with neurodegenerative disorders, such as Parkinson's or Alzheimer's disease. Insomnia in patients with neurological conditions may occur as a direct consequence of the disease itself or may be secondary to factors associated with the condition, such as pain, depression or the effects of medications. Disturbed sleep can have a significant impact on the patient's cognitive and physical function and may be associated with distress and depression. Insomnia also impacts patients' and caregivers' quality of life and is often cited as one of the primary reasons for patient institutionalization. Management of insomnia in patients with neurological disorders should be individualized to each patient's needs. The type of insomnia and any underlying causes of disturbed sleep must first be determined. Non-pharmacological interventions, such as behavioral modification, should be considered for all patients. Bright light therapy may be an effective treatment option for patients with disturbed sleep-wake patterns. Medications causing sleep problems should be withdrawn or doses and/or timing adjusted, whenever possible. Several pharmacological options are available to relieve the symptoms of insomnia as short-term treatment.