To the Editor The regulation of sleep-wakefulness behavior involves 2 physiological processes. A circadian process, based in the suprachiasmatic nucleus, is responsible for the timing of sleep and wakefulness, and a homeostatic process that monitors and responds to the quality and quantity of prior sleep and wakefulness.1 In patients with Parkinson disease (PD), sleep disturbances are among the most debilitating nonmotor symptoms.2 The underlying neuropathology is multifactorial and involves complex disease-medication interactions.2 Given this complex pathophysiology, the contribution of a dysfunctional suprachiasmatic nucleus clock has remained elusive.
Fifel K, DeBoer T. The Central Clock in Patients With Parkinson Disease. JAMA Neurol. 2014;71(11):1455-1456. doi:10.1001/jamaneurol.2014.2708