Excessive Sleepiness Worsens in Parkinson’s As Disease Progresses

the Psychiatry Advisor take:

Clinicians who treat people with early-stage Parkinson’s disease should be on the lookout for symptoms of narcolepsy as many such patients are likely to develop excessive daytime sleepiness (EDS) as their illness worsens.

Michaela Gjerstad, MD, OhD, of the Stavanger University Hospital, Stavanger, Norway, and colleagues enrolled 153 drug-naïve Parkinson’s patients and 169 health controls who were age- and gender-matched. At baseline, 11.8% of the Parkinson’s patients had EDS, compared with just 4.7% of the healthy patients, they reported in the journal Neurology.

Over time, EDS worsened in both groups, but was more severe in the Parkinson’s cohort. After three years, 15.9% of participants in this group had EDS, rising to 23.4% after five years. In comparison, among the healthy patients, the figures were, respectively, 7.2% and 8%.

Higher scores on the Epworth Sleepiness Scale (ESS) were the key predictor of developing EDS later on. In addition, patients who ended taking dopamine agonist drugs during the study, which include ropinirole (Requip) and rotigotine (Neupro), and are used to treat early Parkinson’s, tended to have higher RSS scores.

“Our results may have implications for management because increased sleep propensity at the time of diagnosis may indicate cautiousness when using dopamine agonists in patients with early” Parkinson’s, the researchers wrote.