Evaluation of sleep and driving performance in six patients with Parkinson's disease reporting sudden onset of sleep under dopaminergic medication: a pilot study.
Six patients with Parkinson's disease (PD) reporting unusually fast or sudden onset of sleep under the addition of dopamine agonists to a previous levodopa-containing therapy were examined using a sleep-wake diary, the Epworth sleepiness scale (ESS), polysomnography, multiple sleep latency tests (MSLT), a standardized vigilance test, and driving simulation. In all patients, ESS scores were increased and polysomnography showed disruption of the sleep pattern, a tendency towards poor sleep efficiency, and reduced proportions of slow- wave and rapid eye movement sleep. Pathological results in the MSLT or the vigilance test were obtained in five cases. For evaluation of driving performance, the standard deviation from the mean lane position during driving simulation was calculated. Three of five patients had clearly increased mean SDLP values. With respect to the measurement of daytime sleepiness (ESS, MSLT, vigilance test, and driving simulation), each patient had pathological results in at least two of these examinations. However, only a limited transfer of the routine vigilance assessment to driving performance was possible. In summary, this pilot study indicates that unusually fast or sudden onset of sleep in PD patients is a phenomenon of daytime sleepiness.
Department of Neurology, Philipps University, Marburg, Germany. moellerc@mailer.uni-marburg.de
J Carsten
JC
Möller
Karin
K
Stiasny
Volker
V
Hargutt
Werner
W
Cassel
Heiko
H
Tietze
J Hermann
JH
Peter
H-Peter
HP
Krüger
Wolfgang H
WH
Oertel
D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects*; D001143:Arousal / Q000187:drug effects; D001334:Automobile Driving; D003198:Computer Simulation; D006970:Disorders of Excessive Somnolence / Q000139:chemically induced*; D018491:Dopamine Agonists / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000523:psychology*; D010865:Pilot Projects; D017286:Polysomnography; D011597:Psychomotor Performance / Q000187:drug effects*; D011930:Reaction Time; D012890:Sleep / Q000187:drug effects*
D000978:Antiparkinson Agents; D018491:Dopamine Agonists