Neurology 2002;58:1019-1024
© 2002 American Academy of Neurology
Parkinson’s disease and sleepiness
An integral part of PD
I. Arnulf, MD,
E. Konofal, MD,
M. Merino–Andreu, MD,
J. L. Houeto, MD,
V. Mesnage, MD,
M. L. Welter, MD,
L. Lacomblez, MD,
J. L. Golmard, MD PhD,
J. P. Derenne, MD and
Y. Agid, MD PhD
From Fédération des Pathologies du Sommeil (Drs. Arnulf, Konofal, Merino–Andreu, and Derenne), Centre d’Investigation Clinique, Fédération de Neurologie and Inserm U289 (Drs. Houeto, Mesnage, Welter, and Agid), Service de Neuropharmacologie (Dr. Lacomblez), and Service d’Informatique Médicale (Dr. Golmard), Hôpital Pitié–Salpêtrière, Assistance Publique-Hôpitaux de Paris, France.
Address correspondence and reprint requests to Dr. Isabelle Arnulf, Pavillon Rambuteau, Hôpital Pitié–Salpêtrière, 47-83 Boulevard de l’Hôpital, 75651 Paris Cedex 13, France; e-mail: isabelle.arnulf{at}psl.ap-hop-paris.fr
Objective: To investigate the potential causes of excessive daytime sleepiness in patients with PD—poor sleep quality, abnormal sleep–wakefulness control, and treatment with dopaminergic agents.
Methods: The authors performed night-time polysomnography and daytime multiple sleep latency tests in 54 consecutive levodopa-treated patients with PD referred for sleepiness, 27 of whom were also receiving dopaminergic agonists.
Results: Sleep latency was 6.3 ± 0.6 minutes (normal >8 minutes), and the Epworth Sleepiness score was 14.3 ± 4.1 (normal <10). A narcolepsy-like phenotype ( 2 sleep-onset REM periods) was found in 39% of the patients, who were sleepier (4.6 ± 0.9 minutes) than the other 61% of patients (7.4 ± 0.7 minutes). Periodic leg movement syndromes were rare (15%, range 16 to 43/h), but obstructive sleep apnea–hypopnea syndromes were frequent (20% of patients had an apnea–hypopnea index >15/h; range 15.1 to 50.0). Severity of sleepiness was weakly correlated with Epworth Sleepiness score (r = -0.34) and daily dose of levodopa (r = 0.30) but not with dopamine-agonist treatment, age, disease duration, parkinsonian motor disability, total sleep time, periodic leg movement, apnea–hypopnea, or arousal indices.
Conclusions: In patients with PD preselected for sleepiness, severity of sleepiness was not dependent on nocturnal sleep abnormalities, motor and cognitive impairment, or antiparkinsonian treatment. The results suggest that sleepiness—sudden onset of sleep—does not result from pharmacotherapy but is related to the pathology of PD.
This article has been cited by other articles:
|
|
|
|
 
Y. Compta, J. Santamaria, L. Ratti, E. Tolosa, A. Iranzo, E. Munoz, F. Valldeoriola, R. Casamitjana, J. Rios, and M. J. Marti
Cerebrospinal hypocretin, daytime sleepiness and sleep architecture in Parkinson's disease dementia
Brain,
December 1, 2009;
132(12):
3308 - 3317.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L Laberge, P Begin, Y Dauvilliers, M Beaudry, M Laforte, S Jean, and J Mathieu
A polysomnographic study of daytime sleepiness in myotonic dystrophy type 1
J. Neurol. Neurosurg. Psychiatry,
June 1, 2009;
80(6):
642 - 646.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. W. Olanow, M. B. Stern, and K. Sethi
The scientific and clinical basis for the treatment of Parkinson disease (2009)
Neurology,
May 26, 2009;
72(21_Supplement_4):
S1 - S136.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. PANDYA, C. S. KUBU, and M. L. GIROUX
Parkinson disease: Not just a movement disorder
Cleveland Clinic Journal of Medicine,
December 1, 2008;
75(12):
856 - 864.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. G. Ondo, T. Perkins, T. Swick, K. L. Hull Jr, J. E. Jimenez, T. S. Garris, and D. Pardi
Sodium Oxybate for Excessive Daytime Sleepiness in Parkinson Disease: An Open-Label Polysomnographic Study
Arch Neurol,
October 1, 2008;
65(10):
1337 - 1340.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. C. Thannickal, Y.-Y. Lai, and J. M. Siegel
Hypocretin (orexin) and melanin concentrating hormone loss and the symptoms of Parkinson's disease
Brain,
January 1, 2008;
131(1):
e87 - e87.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Fronczek, S. Overeem, S. Y. Y. Lee, Ingrid. M. Hegeman, J. van Pelt, Sjoerd. G. van Duinen, G. J. Lammers, and D. F. Swaab
Hypocretin (orexin) loss in Parkinson's disease
Brain,
June 1, 2007;
130(6):
1577 - 1585.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. C. Thannickal, Y.-Y. Lai, and J. M. Siegel
Hypocretin (orexin) cell loss in Parkinson's disease
Brain,
June 1, 2007;
130(6):
1586 - 1595.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M D Gjerstad, T Wentzel-Larsen, D Aarsland, and J P Larsen
Insomnia in Parkinson's disease: frequency and progression over time
J. Neurol. Neurosurg. Psychiatry,
May 1, 2007;
78(5):
476 - 479.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. D. Gjerstad, G. Alves, T. Wentzel-Larsen, D. Aarsland, and J. P. Larsen
Excessive daytime sleepiness in Parkinson disease: is it the drugs or the disease?
Neurology,
September 12, 2006;
67(5):
853 - 858.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. Dhawan, D. G. Healy, S. Pal, and K. R. Chaudhuri
Sleep-related problems of Parkinson's disease.
Age Ageing,
May 1, 2006;
35(3):
220 - 228.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Lu, T. C. Jhou, and C. B. Saper
Identification of Wake-Active Dopaminergic Neurons in the Ventral Periaqueductal Gray Matter
J. Neurosci.,
January 4, 2006;
26(1):
193 - 202.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W G Ondo, R Fayle, F Atassi, and J Jankovic
Modafinil for daytime somnolence in Parkinson's disease: double blind, placebo controlled parallel trial
J. Neurol. Neurosurg. Psychiatry,
December 1, 2005;
76(12):
1636 - 1639.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. D. Abbott, G. W. Ross, L. R. White, C. M. Tanner, K. H. Masaki, J. S. Nelson, J. D. Curb, and H. Petrovitch
Excessive daytime sleepiness and subsequent development of Parkinson disease
Neurology,
November 8, 2005;
65(9):
1442 - 1446.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Kume, S. Kume, S. K. Park, J. Hirsh, and F. R. Jackson
Dopamine Is a Regulator of Arousal in the Fruit Fly
J. Neurosci.,
August 10, 2005;
25(32):
7377 - 7384.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Avorn, S. Schneeweiss, L. R. Sudarsky, J. Benner, Y. Kiyota, R. Levin, and R. J. Glynn
Sudden Uncontrollable Somnolence and Medication Use in Parkinson Disease
Arch Neurol,
August 1, 2005;
62(8):
1242 - 1248.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. H. Adler and M. J. Thorpy
Sleep issues in Parkinson's disease
Neurology,
June 28, 2005;
64(12_suppl_3):
S12 - S20.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. B. Rye
The two faces of Eve: Dopamine's modulation of wakefulness and sleep
Neurology,
October 26, 2004;
63(8_suppl_3):
S2 - S7.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
W. Poewe and B. Hogl
Akathisia, restless legs and periodic limb movements in sleep in Parkinson's disease
Neurology,
October 26, 2004;
63(8_suppl_3):
S12 - S16.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
J. Santamaria
How to evaluate excessive daytime sleepiness in Parkinson's disease
Neurology,
October 26, 2004;
63(8_suppl_3):
S21 - S23.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
J. Kulisevsky and E. Roldan
Hallucinations and sleep disturbances in Parkinson's disease
Neurology,
October 26, 2004;
63(8_suppl_3):
S28 - S30.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
P. Barone, M. Amboni, C. Vitale, and V. Bonavita
Treatment of nocturnal disturbances and excessive daytime sleepiness in Parkinson's disease
Neurology,
October 26, 2004;
63(8_suppl_3):
S35 - S38.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
K. R. Chaudhuri
Nocturnal symptom complex in PD and its management
Neurology,
September 23, 2003;
61(90063):
S17 - 23.
[Full Text]
|
|
|
|
|
|
|
X. Drouot, S. Moutereau, J.P. Nguyen, J.P. Lefaucheur, A. Creange, P. Remy, F. Goldenberg, and M.P. d'Ortho
Low levels of ventricular CSF orexin/hypocretin in advanced PD
Neurology,
August 26, 2003;
61(4):
540 - 543.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Merino-Andreu, I. Arnulf, E. Konofal, J. P. Derenne, and Y. Agid
Unawareness of naps in Parkinson's disease and in disorders with excessive daytime sleepiness
Neurology,
May 13, 2003;
60(9):
1553 - 1554.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K R Chaudhuri, S Pal, A DiMarco, C Whately-Smith, K Bridgman, R Mathew, F R Pezzela, A Forbes, B Hogl, and C Trenkwalder
The Parkinson's disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson's disease
J. Neurol. Neurosurg. Psychiatry,
December 1, 2002;
73(6):
629 - 635.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
