Sleep disorders are among the most common non-motor symptoms in Parkinson’s disease (PD) and are associated with reduced cognition and health-related quality of life. Disturbed sleep can often present in the prodromal or early stages of this neurodegenerative disease, rendering it crucial to manage and treat these symptoms. Levodopa and dopaminergic agonists are frequently prescribed to treat motor symptoms in PD and there is increasing interest regarding how these pharmacological agents affect sleep and their effect on concomitant sleep disturbances and disorders. In this review, we discuss the role of dopamine in regulating the sleep-wake state and the impact of neurodegeneration on sleep. We provide an overview of the effects of levodopa and dopaminergic agonists on sleep architecture, insomnia, excessive daytime sleepiness, sleep-disordered breathing, rapid eye movement sleep behavior disorder, and restless legs syndrome in PD. Levodopa and dopaminergic drugs may have different effects, beneficial or adverse, depending on dosing, method of administration and differential effects on the different dopamine receptors. Future research in this area should focus on elucidating the specific mechanisms by which these drugs impact sleep in order to better understand the pathophysiology of sleep disorders in PD and aid in developing suitable therapies and treatment regimens.
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