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Purpose of Review: The aim of this article was to review the options and particularities of the treatment of restless legs syndrome (RLS) in Parkinson's disease (PD)., Recent Findings: RLS is more frequent in PD than in the general population. Even if these two disorders share some specificity (dopa-sensitivity), they also differ in many features (iron load, genetic profile, dopaminergic cell count), resulting in different adaptations of the treatment. Only one study has specifically explored and demonstrated the efficacy of a treatment (rotigotine) in RLS with PD, constraining us to treat RLS with PD by analogy as idiopathic RLS in the other cases. However, arrangements linked to the peculiar population and pathology of PD are required. The treatment of RLS in PD consists in adaptation of dopaminergic treatment and introduction of alpha-2-delta ligands and, in refractory cases, of opioids or deep brain stimulation. Iron deficiency should probably not be compensated.

Purpose of Review: The aim of this article was to review the different sleep disorders associated with Wilson's disease (WD), their mechanisms and their treatments., Recent Findings: Some of these disorders such as REM sleep behavior disorder or sleepiness can appear as a prodromal phase phenomenon in WD allowing an early treatment of the disease and sometimes a resolution of the sleep disorder. Sleep disorders in WD are frequent combining insomnia, daytime sleepiness, restless legs syndrome (RLS), cataplexy-like episodes, and REM sleep behavior disorder (RBD). Sleep recordings confirm these disorders. Mechanisms involved in these disorders are complex associating (a) lesions of the pathways regulating sleep and wake or mood but also controlling movement, (b) iatrogenic effects of the treatments, and (3) consequences of the motor or dysautonomic or metabolic disorders.

Purpose of Review: The purpose of this review was to explore the different sleep disorders associated with MSA, their mechanisms, and their treatments., Recent Findings: Stridor is a red flag for the diagnosis of MSA. Recent findings show that its presence in early stage of the disease is associated with a reduction in life expectancy. Its management should be fast and adapted. Its treatment with continuous positive airway pressure or tracheostomy is efficacious. Sleep disorders in MSA are frequent and severe combining insomnia, daytime sleepiness, restless legs syndrome (RLS), REM sleep behavior disorder (RBD), and sleep disordered breathing (SDB). Sleep recordings confirm these disorders. Mechanisms involved in these disorders are complex associating (a) lesions of the pathways regulating sleep and wake or mood but also controlling movement, (b) iatrogenic effects of the treatments, and (3) consequences of the motor or dysautonomic symptoms. RBD prevalence is very high at the beginning of the motor symptoms but then seems to disappear.

Opinion Statement: Sleepwalking (SW) is a parasomnia, an abnormal behavior occurring during sleep. SW is a non-REM sleep parasomnia, an arousal disorder, like sleep terrors and confusional arousals. SW results from an incomplete arousal from slow-wave sleep, some regions of the cerebral cortex being awake and allowing movement and vision for example and others being asleep, preventing memorization or judgment. Usually, SW is a quiet wandering of a child that occurs rarely (several times a month or a year), requiring no medical advice and treatment. To reassure the family and to secure the environment are the only things to do. However, sometimes, SW can become crippling because of its frequency (several times a week or a night) because of the risks associated with the behavior (going outside, manipulating sharp objects, etc.) or violence (throwing objects, using weapons, etc.) or because of its consequences on everyday quality of life (sleepiness, fatigue, insomnia, anxiety, and depressive symptoms). In these conditions, treatment is required. It first associates sleep hygiene, reduction of alcohol consumption, and interruption of the treatments that could have promoted the episodes and the securing of the environment. The treatment of precipitants inducing sleep fragmentation such as sleep disordered breathing can be beneficial, reducing the number of events. If episodes persist or are too dangerous, medical treatment is needed. No adequate large controlled trial of drugs has yet been conducted in SW so that no medication has been evaluated properly for efficacy or side effects. However, experts in the field use clonazepam. This treatment is in our experience often effective. If inefficacious, antidepressants can also be proposed. Psychotherapy should be associated to improve anxiety and sometimes insomnia. Few published cases have described that deep relaxation, hypnosis, and cognitive behavioral therapy could be effective.