Pharmacological Interventions for Daytime Sleepiness and Sleep Disorders in Parkinson’s Disease: Systematic Review and Meta-Analysis

Abstract Background Daytime sleepiness and sleep disorders are frequently reported in Parkinson’s disease (PD). However, their impact on quality of life has been underestimated and few clinical trials have been performed. Objectives We aimed to assess the efficacy and safety of pharmacological interventions for daytime sleepiness and sleep disorders in PD. Methods Systematic review of randomized controlled trials comparing any pharmacological intervention with no intervention or placebo for the treatment of daytime sleepiness and sleep problems in PD patients. Results Ten studies (n=338 patients) were included. Four trials addressed interventions for excessive daytime sleepiness. Meta-analysis of the three trials evaluating modafinil showed a significant reduction in sleepiness, as assessed by the Epworth Sleepiness Scale (ESS) (– 2.24 points, 95% CI – 3.90 to – 0.57, p