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Before everybody runs out to their neurologist screaming for pramipexole, Please read the following ! I experienced problems with Requip (ropinerol ) and went off the road a number of times, as well as had "mini siezures" where I was doccumented at work to have fallen asleep in the middle of a sentence ! These "sleep attacks" with Requip have been previously doccumented in France and Canada and are nothing to be taken lightly http://neurology.medscape.com/reuters/prof/2001/05/05.11/20010510epid006.html Sleep Attacks Are Common in Parkinson's Disease Patients -------------------------------------------------------------------------------- PHILADELPHIA (Reuters Health) May 10 - Researchers from Atlanta have documented a high prevalence of daytime sleepiness, particularly sleep attacks, in patients with Parkinson's disease (PD). On Wednesday at the 53rd annual meeting of the AmericanAcademy of Neurology, Dr. Natividad P. Stover, of Emory University, presented the results of a survey conducted among 200 consecutive PD patients referred to a movement disorders clinic. The survey aimed to characterize the relative frequency of sleep attacks and their relationship to excessive daytime sleepiness, medications and sleep disorders in their PD population. The mean age of the study population was 68 years, and their mean duration of PD was 10 years. The researchers also obtained data on gender, neurologic and medical diagnoses, medications, medication doses, and sleep patterns. A sleep attack was defined as sudden unintended sleep. The Epworth Sleepiness Scale (ESS), completed by the patient and spouse or significant other, was used to evaluate excessive daytime sleepiness. Sleep attacks were reported in 29 patients, or 14% of those surveyed. Twenty-eight (96%) of 29 patients with sleep attacks reported excessive daytime sleepiness. One hundred forty-four (84%) of 171 patients without sleep attacks reported excessive daytime sleepiness. Age, gender, duration of PD, REM sleep behavior, number of hours of sleep at night, number of naps, snoring, restless legs syndrome, incontinence, and depression were not significantly associated with sleep attacks. Sleep attacks were found to occur with all dopaminergic medications. Pramipexole appeared to have the largest impact on the production of sleep attacks, and its effect was dose-dependent. According to Dr. Stover, the doses of pramipexole used in their clinic are significantly higher than the equivalent doses of pergolide and ropinirole. Sleep attacks were not associated with low-dose pramipexole. No patient in the series had been involved in a car accident or sustained a major injury related to the sleep attacks, she added. Dr. Stover said that prospective epidemiologic and polysomnographic studies are needed to characterize further sleep attacks and sleep disorders in PD patients. Special attention should be paid to patients taking high-dose (greater than 2 mg/day) pramipexole or equivalent doses of the other dopamine agonists with respect to excessive daytime sleepiness and/or sleep attacks. Finally, she urged that PD patients be asked about sleepiness and sleep problems as part of their routine office visit. ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn