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The pharmacological evidence base remains fragmented across phenotypes, drug classes, and outcome instruments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of pharmacological interventions for sleep disorders in PD, stratified by sleep phenotype, through a systematic review and meta-analysis of randomised controlled trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six databases were searched without restrictions. Eligible studies were RCTs in adults with PD and any sleep disturbance. Pooling was performed using random-effects models. Risk of bias was assessed with the Cochrane RoB 2 tool. The protocol was registered in PROSPERO (CRD420261412614).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-nine RCTs (1913 participants; 2002 to 2025) were included. Only 17.2% of trials were at low overall risk of bias. For EDS (k = 6), the pooled ESS estimate was directionally favourable but non-significant (MD 1.75; 95% CI \u22120.26 to 3.75; I\n                      <jats:sup>2<\/jats:sup>\n                      = 91%), driven predominantly by a single influential crossover trial. For overall sleep quality (k = 6), pharmacological treatment produced a statistically significant improvement in PSQI scores (MD 2.66; 95% CI 1.63 to 3.69; I\n                      <jats:sup>2<\/jats:sup>\n                      = 71%). For insomnia symptoms (k = 3) and RBD (k = 2), pooled estimates were non-significant with high heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      = 96% and 99%, respectively), precluding reliable conclusions. Given this level of heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      &gt; 90%), pooled estimates for these two domains, as well as for EDS, are presented as exploratory only and narrative synthesis is emphasised over meta-analytic pooling. No unexpected safety signals were identified, although safety reporting was heterogeneous and quantitative pooling was not performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pharmacological treatment, particularly with chronobiotic agents and dopaminergic receptor agonists, may produce improvement in overall sleep quality (low-certainty evidence). Evidence for EDS, insomnia symptoms, and RBD remains insufficient for definitive recommendations, and pooled estimates in these domains should not be over-interpreted given their very high statistical heterogeneity. Phenotype-specific RCTs with harmonised outcome measures are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00415-026-14158-5","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:42:26Z","timestamp":1790250146000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacological treatment of sleep disorder phenotypes in Parkinson\u2019s disease: a systematic review and meta-analysis of randomised controlled trials"],"prefix":"10.1007","volume":"273","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2238-0556","authenticated-orcid":false,"given":"Jaquelini Betta","family":"Canever","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Cechinel","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Samara","family":"Apio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena Iturvides","family":"Cimarosti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"14158_CR1","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1111\/ene.14108","volume":"27","author":"R Balestrino","year":"2020","unstructured":"Balestrino R, Schapira AHV (2020) Parkinson disease. 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