Sleep Disorders in Atypical Parkinsonism

Sleep disorders are commonly observed in atypical parkinsonism, with particular disorders occurring more frequently in specific parkinsonian disorders. Multiple system atrophy (MSA) is a synucleinopathy often associated with nocturnal stridor, which is a serious, but treatable, condition highly specific to MSA. In addition, this disorder is strongly associated with rapid eye movement sleep behavior disorder (RBD), which is also observed in dementia with Lewy bodies. RBD is far less prevalent in progressive supranuclear palsy (PSP), which is a tauopathy. Insomnia and impaired sleep architecture are the most common sleep abnormalities observed in PSP. Corticobasilar degeneration is also a tauopathy, but has far fewer sleep complaints associated with it than PSP. In this article, we review the spectrum of sleep dysfunction across the atypical parkinsonian disorders, emphasize the importance of evaluating for sleep disorders in patients with parkinsonian symptoms, and point to sleep characteristics that can provide diagnostic clues to the underlying parkinsonian disorder.