[Obstructive sleep apnea in patients with Parkinson's disease--report of two cases and review].

BACKGROUND: The use of continuous positive airway pressure (CPAP) is well established in treatment of moderate and severe obstructive sleep apnea syndrome (OSAS). The judgement of clinical symptoms like daytime sleepiness and hypersomnolence with loss in concentration is complicated in patients with diagnosis of Morbus Parkinson (MP) because the disease itself and pharmacologic therapy may mimic clinical features of OSAS.

PATIENTS AND METHODS: Diagnostic pathways and differential diagnostic considerations are demonstrated in two case reports of patients with MP and OSAS. The cases are discussed within the framework of literature concerning sleep disturbances and MP.

RESULTS: In both cases respiration could be treated effectively by continuous positive airway pressure (CPAP). Patients clearly responded to therapy and regained more daytime activity. The medication for MP was satisfactory.

CONCLUSIONS: The evaluation and treatment of daytime sleepiness in patients with MP and obstructive sleep apnea need an interdisciplinary framework with a practitioner, a neurologist, and a sleep expert. Associated symptoms as increased nycturia, hypokinesia, restless-leg-symptoms, and depression as well as the effects of medication may mimic details of concomitant sleep apnea. Therefore, sleep diagnostic evaluation is recommended to rule out sleep apnea as a frequent cause for hypersomnolence.