Fig. 1.

Treatment flow chart for insomnia in Parkinson’s disease (PD). Motor symptoms from PD such as tremor, dystonia, and rigidity can contribute to insomnia. The treatment of nocturnal symptoms typically employs long-acting forms of antiparkinsonian medication to last through a night of sleep. Nocturia is a symptom of PD that can significantly disrupt sleep and may be treated with behavioral modification and medications with low side effect profiles. Mood disturbances commonly contribute to insomnia and may be treated with a combination of nonpharmacologic measures and antidepressant medication