Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson's disease
Identifieur interne : 001710 ( Main/Exploration ); précédent : 001709; suivant : 001711Sleep attacks, daytime sleepiness, and dopamine agonists in Parkinson's disease
Auteurs : Sebastian Paus [Allemagne] ; Hans Michael Brecht [Allemagne] ; Jürgen Köster [Allemagne] ; Gert Seeger [Allemagne] ; Thomas Klockgether [Allemagne] ; Ullrich Wüllner [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2003-06.
English descriptors
- KwdEn :
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 ≤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 (α‐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. © 2003 Movement Disorder Society
Url:
DOI: 10.1002/mds.10417
Affiliations:
- Allemagne
- Bade-Wurtemberg, District de Cologne, District de Karlsruhe, Rhénanie-du-Nord-Westphalie
- Bonn, Mannheim
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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 ≤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 (α‐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. © 2003 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Bade-Wurtemberg</li><li>District de Cologne</li><li>District de Karlsruhe</li><li>Rhénanie-du-Nord-Westphalie</li></region><settlement><li>Bonn</li><li>Mannheim</li></settlement></list><tree><country name="Allemagne"><region name="Rhénanie-du-Nord-Westphalie"><name sortKey="Paus, Sebastian" sort="Paus, Sebastian" uniqKey="Paus S" first="Sebastian" last="Paus">Sebastian Paus</name></region><name sortKey="Brecht, Hans Michael" sort="Brecht, Hans Michael" uniqKey="Brecht H" first="Hans Michael" last="Brecht">Hans Michael Brecht</name><name sortKey="Klockgether, Thomas" sort="Klockgether, Thomas" uniqKey="Klockgether T" first="Thomas" last="Klockgether">Thomas Klockgether</name><name sortKey="Koster, Jurgen" sort="Koster, Jurgen" uniqKey="Koster J" first="Jürgen" last="Köster">Jürgen Köster</name><name sortKey="Seeger, Gert" sort="Seeger, Gert" uniqKey="Seeger G" first="Gert" last="Seeger">Gert Seeger</name><name sortKey="Wullner, Ullrich" sort="Wullner, Ullrich" uniqKey="Wullner U" first="Ullrich" last="Wüllner">Ullrich Wüllner</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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