Sudden-Onset Sleep in Parkinson Disease

Sleep and daytime sleepiness in Parkinson's disease

“…A misperception of sleepiness seems also reflected in the relatively low ESS scores of PD patients in many surveys (see above) and the high frequency of dozing during the day [31]. Despite this, the overall rate of falling asleep while driving in PD patients is still controverse and might be lower than expected on the basis of the above data, ranging from an annual incidence rate of 2% [87] to a frequency of 3.8% [56]. However, a recent study has reported that 20.8% of 101 patients had experienced a sleep episode while driving [88], which is still similar to data obtained from Finnish truck drivers [89].…”

A randomized trial of a low‐dose Rasagiline and Pramipexole combination (P2B001) in early Parkinson's disease

“…Dopamine agonists have been used as an initial therapy to delay the introduction of levodopa and the risk of developing motor complications, but they are less effective than levodopa in treating motor features. Furthermore, dopamine agonists are associated with potentially serious side‐effects, including excess daytime sleepiness with a risk of sudden onset sleep episodes in dangerous situations such as driving, impulse control disorders, and other troublesome features such as psychosis and lower extremity edema . Many of these side effects occur with increased frequency with higher doses .…”

Pharmacotherapy of Restless Legs Syndrome with Pramipexole

“…These sleep attacks were put in relationship with a possible downregulation of dopaminergic input to the reticular activating system, maybe by acting on presynaptic receptors, which are stimulated by lower doses of these agents. 54 Several further cases have been described afterward, even with the levodopa and the other ergot or nonergoline dopamine-agonists derivates. 55 In the majority of the cases males were predominant, the sleep attacks occurred at both high and low doses of the drugs, with different durations of treatment (0-20 years), and with or without advice signs.…”