Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson's disease.
Identifieur interne : 000A77 ( Ncbi/Curation ); précédent : 000A76; suivant : 000A78Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson's disease.
Auteurs : Sebastian Paus [Allemagne] ; Hans Michael Brecht ; Jürgen Köster ; Gert Seeger ; Thomas Klockgether ; Ullrich WüllnerSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2003.
English descriptors
- KwdEn :
- Activities of Daily Living, Aged, Analysis of Variance, Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Disorders of Excessive Somnolence (chemically induced), Disorders of Excessive Somnolence (physiopathology), Dopamine Agonists (adverse effects), Dopamine Agonists (therapeutic use), Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Parkinson Disease (drug therapy), Questionnaires, Risk Factors, Sleep (drug effects).
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Dopamine Agonists.
- chemical , therapeutic use : Antiparkinson Agents, Dopamine Agonists.
- chemically induced : Disorders of Excessive Somnolence.
- drug effects : Sleep.
- drug therapy : Parkinson Disease.
- physiopathology : Disorders of Excessive Somnolence.
- Activities of Daily Living, Aged, Analysis of Variance, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Questionnaires, Risk Factors.
Abstract
To study the putative association of dopamine agonists with sleep attacks in patients with Parkinson's disease (PD) and their relation to daytime sleepiness, we performed a survey of 2,952 PD patients in two German counties. In 177 patients, sudden, unexpected, and irresistible sleep episodes while engaged in some activity were identified in a structured telephone interview. Ninety-one of these patients denied the occurrence of appropriate warning signs. A total of 133 patients (75%) had an Epworth Sleepiness Scale (ESS) score >10; 65 (37%) >15. Thirty-one patients (18%) had an ESS score < or =10 and yet experienced sleep attacks without warning signs. Thus, although a significant proportion of patients at risk for sleep attacks might be identified using the ESS, roughly 1% of the PD patient population seems to be at risk for sleep attacks without appropriate warning signs and without accompanying daytime sleepiness. Sleep attacks occurred with all dopamine agonists marketed in Germany (alpha-dihydroergocryptine, bromocriptine, cabergoline, lisuride, pergolide, pramipexole, ropinirole), and no significant difference between ergot and nonergot drugs was evident. Levodopa (L-dopa) monotherapy carried the lowest risk for sleep attacks (2.9%; 95% confidence interval [CI], 1.7-4.0%) followed by dopamine agonist monotherapy (5.3%; 95% CI, 1.5-9.2%) and combination of L-dopa and a dopamine agonist (7.3%; 95% CI, 6.1-8.5%). Neither selegeline nor amantadine or entacapone appeared to influence the occurrence of sleep attacks. A high ESS score, intake of dopamine agonists, and duration of PD were the main influencing factors for the occurrence of sleep attacks. The odds ratio for dopamine agonist therapy was 2.9 compared to 1.9 with L-dopa therapy and 1.05 for a 1-year-longer disease duration.
DOI: 10.1002/mds.10417
PubMed: 12784269
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uniqKey="Koster J" first="Jürgen" last="Köster">Jürgen Köster</name></author><author><name sortKey="Seeger, Gert" sort="Seeger, Gert" uniqKey="Seeger G" first="Gert" last="Seeger">Gert Seeger</name></author><author><name sortKey="Klockgether, Thomas" sort="Klockgether, Thomas" uniqKey="Klockgether T" first="Thomas" last="Klockgether">Thomas Klockgether</name></author><author><name sortKey="Wullner, Ullrich" sort="Wullner, Ullrich" uniqKey="Wullner U" first="Ullrich" last="Wüllner">Ullrich Wüllner</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2003">2003</date><idno type="RBID">pubmed:12784269</idno><idno type="pmid">12784269</idno><idno type="doi">10.1002/mds.10417</idno><idno type="wicri:Area/PubMed/Corpus">003774</idno><idno type="wicri:Area/PubMed/Curation">003774</idno><idno type="wicri:Area/PubMed/Checkpoint">003632</idno><idno type="wicri:Area/Ncbi/Merge">000A77</idno><idno type="wicri:Area/Ncbi/Curation">000A77</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson's disease.</title><author><name sortKey="Paus, Sebastian" sort="Paus, Sebastian" uniqKey="Paus S" first="Sebastian" last="Paus">Sebastian Paus</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, University of Bonn, Bonn, Germany. spaus@uni-bonn.de</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, University of Bonn, Bonn</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Bonn</settlement></placeName></affiliation></author><author><name sortKey="Brecht, Hans Michael" sort="Brecht, Hans Michael" uniqKey="Brecht H" first="Hans Michael" last="Brecht">Hans Michael Brecht</name></author><author><name sortKey="Koster, Jurgen" sort="Koster, Jurgen" uniqKey="Koster J" first="Jürgen" last="Köster">Jürgen Köster</name></author><author><name sortKey="Seeger, Gert" sort="Seeger, Gert" uniqKey="Seeger G" first="Gert" last="Seeger">Gert Seeger</name></author><author><name sortKey="Klockgether, Thomas" sort="Klockgether, Thomas" uniqKey="Klockgether T" first="Thomas" last="Klockgether">Thomas Klockgether</name></author><author><name sortKey="Wullner, Ullrich" sort="Wullner, Ullrich" uniqKey="Wullner U" first="Ullrich" last="Wüllner">Ullrich Wüllner</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2003" type="published">2003</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term><term>Aged</term><term>Analysis of Variance</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson Agents (therapeutic use)</term><term>Disorders of Excessive Somnolence (chemically induced)</term><term>Disorders of Excessive Somnolence (physiopathology)</term><term>Dopamine Agonists (adverse effects)</term><term>Dopamine Agonists (therapeutic use)</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (drug therapy)</term><term>Questionnaires</term><term>Risk Factors</term><term>Sleep (drug effects)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Disorders of Excessive Somnolence</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Sleep</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Disorders of Excessive Somnolence</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term><term>Aged</term><term>Analysis of Variance</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Questionnaires</term><term>Risk Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To study the putative association of dopamine agonists with sleep attacks in patients with Parkinson's disease (PD) and their relation to daytime sleepiness, we performed a survey of 2,952 PD patients in two German counties. In 177 patients, sudden, unexpected, and irresistible sleep episodes while engaged in some activity were identified in a structured telephone interview. Ninety-one of these patients denied the occurrence of appropriate warning signs. A total of 133 patients (75%) had an Epworth Sleepiness Scale (ESS) score >10; 65 (37%) >15. Thirty-one patients (18%) had an ESS score < or =10 and yet experienced sleep attacks without warning signs. Thus, although a significant proportion of patients at risk for sleep attacks might be identified using the ESS, roughly 1% of the PD patient population seems to be at risk for sleep attacks without appropriate warning signs and without accompanying daytime sleepiness. Sleep attacks occurred with all dopamine agonists marketed in Germany (alpha-dihydroergocryptine, bromocriptine, cabergoline, lisuride, pergolide, pramipexole, ropinirole), and no significant difference between ergot and nonergot drugs was evident. Levodopa (L-dopa) monotherapy carried the lowest risk for sleep attacks (2.9%; 95% confidence interval [CI], 1.7-4.0%) followed by dopamine agonist monotherapy (5.3%; 95% CI, 1.5-9.2%) and combination of L-dopa and a dopamine agonist (7.3%; 95% CI, 6.1-8.5%). Neither selegeline nor amantadine or entacapone appeared to influence the occurrence of sleep attacks. A high ESS score, intake of dopamine agonists, and duration of PD were the main influencing factors for the occurrence of sleep attacks. The odds ratio for dopamine agonist therapy was 2.9 compared to 1.9 with L-dopa therapy and 1.05 for a 1-year-longer disease duration.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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