Contributions of Dopaminergic Drugs and Disease Severity to Daytime Sleepiness in Parkinson Disease

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Abstract
DAYTIME SOMNOLENCE in Parkinson disease (PD) has been recognized for many years. Poorly restorative sleep and parkinsonian fatigue probably contribute to daytime drowsiness, while some patients experience sedation as an adverse effect of dopaminergic drugs. Occupational capacity and domestic quality of life are clearly reduced when people feel groggy rather than alert. The prevalent report of drowsiness in PD should probably be treated separately from the uncommon "sleep attacks," a term introduced in 1999 to describe the unheralded onset of sleep in potentially dangerous circumstances.1 Onset of sleep without prodromal sedation has been widely discussed since then2-19 and is generally thought to be associated with the use of dopaminergic drugs, more specifically with dopamine agonists. Herein we contribute our experience with the less dangerous, but more common, problem of excessive drowsiness in PD. In this article we try to separate and quantify the contributions of disease markers and drug doses.