title: Sleep attacks in patients taking dopamine agonists: review.
abstract: 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.
authors.affiliation: Department of Neurology, Karl Franzens University Hospital, A-8036 Graz, Austria. nik.homann@kfunigraz.ac.at
authors.forename: Carl Nikolaus
authors.initials: CN
authors.lastname: Homann
authors.forename: Karoline
authors.initials: K
authors.lastname: Wenzel
authors.forename: Klaudia
authors.initials: K
authors.lastname: Suppan
authors.forename: Gerd
authors.initials: G
authors.lastname: Ivanic
authors.forename: Norbert
authors.initials: N
authors.lastname: Kriechbaum
authors.forename: Richard
authors.initials: R
authors.lastname: Crevenna
authors.forename: Erwin
authors.initials: E
authors.lastname: Ott
mesh_terms: 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
chemical_list: D018491:Dopamine Agonists