How Sleep Problems Could Tell You About Parkinson's Years Ago - Dr Vikram Sharma
Many people think of Parkinson's disease (PD) as a movement condition that causes people to shake their hands, move slowly, or become stiff. But what if it wasn't moving that showed the first signs of Parkinson's?
What if they started out in sleep? More and more studies are showing that sleep problems, especially REM Sleep Behaviour Disorder (RBD), may be an early sign of neurodegeneration that can show up years or even decades before someone is diagnosed with Parkinson's.
What does REM Sleep Behaviour Disorder (RBD) mean?
During normal REM (rapid eye movement) sleep, the brain tells the body to stay still so that we don't act out our thoughts. In REM Sleep Behaviour Disorder (RBD), however, this process doesn't work right. In their dreams, people with RBD often move, talk, yell, or even punch and kick. The dreams are often vivid and aggressive.
RBD is a serious disease that is linked to changes in the brain. It is different from occasional sleep talking or twitching. Studies have shown that over 80% of people who are diagnosed with RBD will eventually get Parkinson's disease or a similar neurodegenerative condition.
What Does RBD Tell Us About Parkinson's?
Parkinson's disease happens when neurons that make dopamine slowly die, mostly in the brain's substantia nigra. Scientists now think that the disease may begin much earlier and affect other parts of the nervous system first, such as the parts of the brain stem that control sleep.
Researchers think that RBD is an "early symptom" of this neurodegenerative process. It shows up a long time before the typical motor symptoms of Parkinson's do. RBD often shows up 10 to 15 years before it is diagnosed, which means there may be time to start treatment early.
Can Sleep Studies Help Find Problems Early?
It is possible for RBD to show up before other Parkinson's signs, so finding it early may help find people who are more likely to have neurodegeneration. Polysomnography, a type of sleep study that records brain activity, muscle movements, and breathing patterns while a person sleeps, can prove RBD.
Some experts say that regular sleep screenings for people who are at high risk, especially those who have a family history of Parkinson's, could be a big step forward in finding the disease early.
Biomarkers, like certain proteins in cerebrospinal fluid or abnormal alpha-synuclein deposits (a key feature of Parkinson's pathology), are also being looked into as ways to prove that people with RBD are at a high risk for getting the disease.
If RBD is Found Early, What can be done?
Just because someone has RBD doesn't mean they will get Parkinson's right away. But it is a very important warning sign that should lead to more careful neurological tracking. What can be done is this:
1. Changes to your lifestyle: A Mediterranean diet, regular exercise, and mental activity may all help slow neurodegeneration.
2. Neuroprotective Research: Researchers are trying drugs that might slow or stop the progression of Parkinson's disease in people who are at a high risk of getting it.
3. Safety Measures: Because RBD can cause injuries while sleeping, patients should take care by putting soft things under their beds and taking away any sharp items from their sides.
4. Regular Neurological Check-ups: Seeing a neurologist regularly to talk about your symptoms can help you find early signs of Parkinson's disease and start treatment sooner.
What's Next for Sleep and Parkinson's Research?
One of the most interesting areas of neurology study is the link between sleep and Parkinson's. If we can find people who are at risk *years before signs show up, we might be able to help them sooner and maybe even stop the disease from getting worse.
As sleep studies, biomarker research, and neuroprotective treatments get better, we are getting closer to a time when Parkinson's can be found and treated long before its most painful signs show up.
Figuring out what RBD means isn't just about getting better sleep; it's about finding out important things about one of the hardest brain diseases we face today.
Dr Vikram Sharma (MBBS, MD, MRCP, Dip. Neurology (London), FAAN (USA)) is the Clinical Director & Senior Consultant Neurologist at CARE Hospitals, Banjara Hills, Hyderabad. with over 22 years of clinical experience. He completed his MBBS/MD from Yerevan State Medical University, Yerevan. He later earned a Diploma in Clinical Neurology from University College London in 2001 and obtained the MRCP in 2021. He is also a Fellow of the American Academy of Neurology (FAAN). His clinical interests include stroke, epilepsy, migraine, sleep disorders, cervical and lumbar pain, movement disorders, multiple sclerosis, and diabetic neuropathy. Dr. Sharma has worked in various hospitals and has been involved in developing services such as stroke thrombolysis and clinics for epilepsy and pain management. He has also participated in studies related to stroke, epilepsy, and headache. His work has contributed to the development of neurosciences departments that support coordinated care across specialties, including surgical and radiological services.