Effect of controlled-release levodopa on the microstructure of sleep in Parkinson's disease.
BACKGROUND
Dopamine is an important neurotransmitter in the regulation of the sleep-wake cycle, and parkinsonian patients suffer from prominent sleep abnormalities. Hence, the question arises whether the disrupted sleep pattern in Parkinson's disease (PD) is responsive to dopaminergic treatment.


METHODS
Thirty-two patients (18 women, 45-82 years old; mean 61 ± 8 years) with dopamine-responsive, akinetic-rigid PD, not taking neuroleptic medication or suffering from dementia were randomized into two groups. Both groups had to withhold their usual dopaminergic medication after noon. At bedtime, one group received 200 mg controlled-release (CR) levodopa/carbidopa, whilst the other group spent the night in the 'off'-state. Polysomnographic recordings were obtained in all patients and 16 age-matched, healthy controls.


RESULTS
Compared to healthy controls, patients with PD suffered from significantly decreased total sleep time, REM sleep and slow wave sleep (SWS), whilst the time spent awake was increased. The administration of levodopa/carbidopa CR had no impact on any of these variables.


CONCLUSIONS
Levodopa/carbidopa CR has previously been found effective for treating night-time akinesia, but according to this study, it has no impact on the altered sleep structure in PD.
Wailke
S
S
Department of Neurology, University-Hospital Schleswig-Holstein, Campus Kiel, Germany.
Herzog
J
J
Witt
K
K
Deuschl
G
G
Volkmann
J
J
D000368:Aged; D000369:Aged, 80 and over; D002230:Carbidopa / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D017286:Polysomnography; D012890:Sleep / Q000187:drug effects*; D012893:Sleep Wake Disorders / Q000188:drug therapy* / Q000209:etiology
D003692:Delayed-Action Preparations; D018491:Dopamine Agonists; D004338:Drug Combinations; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa