Targeting sleep and the circadian system as a novel treatment strategy for Parkinson’s disease

Beatrix Feigl, Simon J. G. Lewis*, Oliver Rawashdeh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


There is a growing appreciation of the wide range of sleep–wake disturbances that occur frequently in Parkinson’s disease. These are known to be associated with a range of motor and non-motor symptoms and significantly impact not only on the quality of life of the patient, but also on their bed partner. The underlying causes for fragmented sleep and daytime somnolence are no doubt multifactorial but there is clear evidence for circadian disruption in Parkinson’s disease. This appears to be occurring not only as a result of the neuropathological changes that occur across a distributed neural network, but even down to the cellular level. Such observations indicate that circadian changes may in fact be a driver of neurodegeneration, as well as a cause for some of the sleep–wake symptoms observed in Parkinson’s disease. Thus, efforts are now required to evaluate approaches including the prescription of precision medicine to modulate photoreceptor activation ratios that reflect daylight inputs to the circadian pacemaker, the use of small molecules to target clock genes, the manipulation of orexin pathways that could help restore the circadian system, to offer novel symptomatic and novel disease modifying strategies.

Original languageEnglish
Pages (from-to)1483-1491
Number of pages9
JournalJournal of Neurology
Issue number3
Publication statusPublished - Mar 2024
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2023. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Chronobiology
  • Circadian
  • Disease modifying Therapy
  • Neurodegeneration
  • Orexin
  • Photoreceptor
  • Small molecule


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