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Cited by 169Parkinson's Disease Mechanisms and TreatmentsSleep and Work-Related FatigueSleep and related disorders

Sleepiness in Parkinson's disease: A controlled study

Brodsky, Matthew A., Godbold, James, Roth, Tom, Olanow, C. Warren·2003·Movement Disorders
DOI 10.1002/mds.10429
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Abstract

Sudden‐onset sleep episodes while driving have been reported in Parkinson's disease (PD) patients, and termed sleep attacks because they were reported to be irresistible and to occur without warning. We postulate that these episodes are due to excessive daytime sleepiness secondary to the high frequency of sleep disorders in PD patients and the sedative effects of dopaminergic medications. We assessed the frequency and relationship between excess daytime sleepiness and sleep episodes while driving (SE) in patients with PD. We evaluated 101 consecutive PD patients presenting to the Movement Disorder Center at the Mount Sinai School of Medicine using a questionnaire that incorporated a subjective estimate of sleepiness, the Epworth Sleepiness Scale (ESS) and information on disease severity and dopaminergic medications. One hundred age‐matched respondents without PD served as a control population. Excess daytime sleepiness was reported in 76% of PD patients compared to 47% of controls (P < 0.05). The mean ESS scores for PD patients was 9.1 ± 6.1 versus 5.7 ± 4.4 in controls (P < 0.001). ESS scores ≥10 were observed in 40.6% of PD patients compared to 19% of controls (P < 0.01) and 24% of PD patients had scores ≥15, compared to 5% of controls (P < 0.001). Sleep episodes while driving were experienced by 20.8% of PD drivers compared to 6% of control drivers (P < 0.05). The mean daily levodopa (L‐dopa) dose equivalent was 1,142 ± 858 mg in PD drivers who experienced a SE while driving compared to 626 ± 667 mg in those who had not (P < 0.05). Similarly, ESS was significantly greater in drivers with a SE than in those without (11.6 ± 6.4 vs. 8.4 ± 4.1; P < 0.05). Logistic regression analysis demonstrated that ESS and mean daily L‐dopa dose equivalents were predictors of sleep episodes while driving, whereas age, gender, disease severity, and individual dopaminergic agents were not. These findings support the notion that sleep episodes while driving in PD patients are related to excess daytime sleepiness and dopaminergic load. Physicians should advise and treat patients accordingly. © 2003 Movement Disorder Society

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  • The dopaminergic treatment load may be implicated in sleep attacks in Parkinson's disease.

    “and the dopaminergic treatment load may be implicated (Brodsky et al. 2003).”

    From The clinical symptoms of Parkinson's disease. (2016) · cites this paper as Brodsky et al. 2003

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Authors
Brodsky, M. A., Godbold, J., Roth, T., & Olanow, C. W.
Affiliations
  • Icahn School of Medicine at Mount Sinai (US)
  • Henry Ford Hospital (US)
Corresponding author
Olanow, C. Warren
ORCID
Venue
Movement Disorders
Publisher
Wiley
Published
2003-05-28
Volume
18
Issue
6
Pages
668-672
ISSN
  • 0885-3185 (ISSN-L)
  • 1531-8257
DOI
10.1002/mds.10429
OpenAlex
W2162060073
Cited by
169
References
32
Citations by year
2025: 2 · 2023: 4 · 2022: 4 · 2021: 7 · 2020: 2 · 2019: 7 · 2018: 5 · 2017: 6 · 2016: 7 · 2015: 8 · 2014: 9 · 2013: 7 · 2012: 6
FWCI
6.78
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Movement Disorders (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
Parkinson's disease, excessive daytime sleepiness, sleep attacks, Epworth Sleepiness Scale, levodopa dose, dopaminergic therapy, sleep disorders, driving safety
MeSH terms
Contraindications, Adult, Aged, Analysis of Variance, Antiparkinson Agents, Female, Humans, Disorders of Excessive Somnolence, Levodopa, Male, Middle Aged, Parkinson Disease, Surveys and Questionnaires, Sleep Stages

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