Excessive Sleepiness Worsens in Parkinson’s As Disease Progresses

Researchers find narcolepsy symptoms the most severe in patients taking dopamine agonists, so clinicians should be cautious in using them.

Many patients with early Parkinson’s disease (PD) develop excessive daytime sleepiness (EDS) as their condition progresses, a study shows.

The major predictor of later EDS was higher scores on the Epworth Sleepiness Scale (ESS) at baseline, report Michaela Gjerstad (Stavanger University Hospital, Norway) and co-workers. And they also found that, during follow-up, dopamine agonist use was associated with higher ESS scores.

At baseline, 11.8% of 153 drug-naïve PD patients had EDS (ESS≥11), compared with 4.7% of 169 age- and gender-matched healthy controls. Although EDS did not always persist within the same patients between visits, the diagnosis “became more persistent and robust as the disease developed,” which the researchers attribute to irreversible changes in brain areas involved in sleep–wake regulation.

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