Parkinson's disease (PD) is a chronic, progressive, neurodegenerative disease that affects 1% of elderly people.  Sleep disturbances affect up to 88% of patients with PD and commonly include sleep fragmentation and excessive daytime sleepiness (EDS); these symptoms can significantly impair quality of life.  The cause of sleep fragmentation and EDS is likely multifactorial, including medications, neurodegeneration, primary sleep disorders such as sleep apnea, and decreased physical activity.  Pharmacotherapy in this population is limited due to side effects and drug-drug interactions. 

The goal of this project is to develop non-pharmacologic therapies for impaired sleep quality and EDS in PD.  Sleep disturbances and EDS are common among patients with PD and negatively affect their quality of life.  There is data to support a role for physical activity in sleep in older adults with and without insomnia.  Additionally, increased physical activity in patients with PD has been associated with improvement in PD motor symptoms and quality of life.  Therefore, the investigators propose to examine the ability of structured physical activity to improve sleep quality and daytime sleepiness in patients with PD. 

The overall objective of the proposed project is to develop behavioral approaches to improve sleep quality and daytime function in PD.  The investigators propose to examine the effect of a structured physical activity program and sleep hygiene education on nighttime sleep quality and EDS in patients with idiopathic PD.  There will be two groups: 1) a structured physical activity program with sleep hygiene education (SPA group), and 2) a control group receiving only sleep hygiene education (SH group) who will be offered the delayed physical activity program. 

The investigators hypothesize that the structured physical activity program will improve subjective and objective sleep quality and daytime sleepiness compared to sleep hygiene education alone. 

Eligibility

Ages Eligible for Study:

50 Years and older

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

No

Criteria

Inclusion Criteria:

Established clinical diagnosis of Hoehn and Yahr stage I to III idiopathic Parkinson's disease,

After clinical evaluation, was provided with a referral by their Movement Disorders Neurologist for an evaluation at the Movement Disorders Rehabilitation Evaluation Clinic at the Rehabilitation Institute of Chicago. 

High likelihood of sleep disordered breathing as determined by the Berlin Questionnaire (BQ);

Restless legs syndrome (RLS) based on the International RLS Study Group diagnostic criteria;

Current use of any sedative/hypnotics or stimulants, tricyclic antidepressants, and trazodone;

Use of selective serotonin reuptake inhibitors (SSRIs) and bupropion will be allowed only if the patient has been on a stable dose for at least three months;

Unstable medical or psychiatric condition;

History of falls in the last 2 months;

Participants with parasomnias such as Rapid Eye Movement Behavior Disorder will not be excluded as up to 50% of patients with PD have parasomnias and exclusion of these patients would result in difficulty with recruitment and the results would be less generalizable;

At physiatry evaluation at RIC, inpatient rehabilitation is recommended. 

Contacts and Locations

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Please refer to this study by its ClinicalTrials.gov identifier: NCT01544465