Sleep attacks in patients taking dopamine agonists: review.
OBJECTIVE
To assess the evidence for the existence and prevalence of sleep attacks in patients taking dopamine agonists for Parkinson's disease, the type of drugs implicated, and strategies for prevention and treatment.


METHODS
Review of publications between July 1999 and May 2001 in which sleep attacks or narcoleptic-like attacks were discussed in patients with Parkinson's disease.


RESULTS
124 patients with sleep events were found in 20 publications. Overall, 6.6% of patients taking dopamine agonists who attended movement disorder centres had sleep events. Men were over-represented. Sleep events occurred at both high and low doses of the drugs, with different durations of treatment (0-20 years), and with or without preceding signs of tiredness. Sleep attacks are a class effect, having been found in patients taking the following dopamine agonists: levodopa (monotherapy in 8 patients), ergot agonists (apomorphine in 2 patients, bromocriptine in 13, cabergoline in 1, lisuride or piribedil in 23, pergolide in 5,) and non-ergot agonists (pramipexole in 32, ropinirole in 38). Reports suggest two distinct types of events: those of sudden onset without warning and those of slow onset with prodrome drowsiness.


CONCLUSIONS
Insufficient data are available to provide effective guidelines for prevention and treatment of sleep events in patients taking dopamine agonists for Parkinson's disease. Prospective population based studies are needed to provide this information.
Homann
Carl Nikolaus
CN
Department of Neurology, Karl Franzens University Hospital, A-8036 Graz, Austria. nik.homann@kfunigraz.ac.at
Wenzel
Karoline
K
Suppan
Klaudia
K
Ivanic
Gerd
G
Kriechbaum
Norbert
N
Crevenna
Richard
R
Ott
Erwin
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving; D018491:Dopamine Agonists / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D011446:Prospective Studies; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000139:chemically induced* / Q000188:drug therapy
D018491:Dopamine Agonists