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Jorge and others, If you look again closely at the HealthScout homepage you will see the "Advertisment" tag refers to the banner directly underneath it -- not to the report itself. HealthScout is a health news portal - one of many that collects news from many different sources, some reliable, others not so - then repackages it for the consumer. Their web sites are a mix of news reports, links to valuable information sources and also to "sponsors" and advertisements - and it's difficult to tell what's what. When in doubt - go to the original source -- if you are able to find it and it's freely available on the Web. In this case the full article is on the JAMA website www.jama.com (as of 6 AM today) The abstract is below. This study was conducted by highly regarded PD researchers and published by JAMA, a peer reviewed medical journal originally. Also note at the end of most reputable medical journal articles is a funding statement - who supported the research and how the funder was involved. Drug companies often do sponsor such research, but there are controls over their involvement as in this study. (see below) Also included are the affiliations and sponoring institution of the investigators - another way to evaluate the study. It's getting more and more difficult on the Web to separate the medical facts from the media hype and from the advertising. Our best weapon is to Know your source. Linda ------------------------- FROM Journal of the American Medical Association Online : Excessive Daytime Sleepiness and Sudden-Onset Sleep in Parkinson Disease A Survey by the Canadian Movement Disorders Group Douglas E. Hobson, MD, FRCPC; Anthony E. Lang, MD, FRCPC; W. R. Wayne Martin, MD, FRCPC; Ajmal Razmy, BSc; Jean Rivest, MD, FRCPC; Jonathan Fleming, MD, FRCPC Excessive Daytime Sleepiness and Sudden-Onset Sleep in Parkinson Disease A Survey by the Canadian Movement Disorders Group Douglas E. Hobson, MD, FRCPC; Anthony E. Lang, MD, FRCPC; W. R. Wayne Martin, MD, FRCPC; Ajmal Razmy, BSc; Jean Rivest, MD, FRCPC; Jonathan Fleming, MD, FRCPC Context Somnolence is a recognized adverse effect of dopamine agonists. Two new dopamine agonists, pramipexole and ropinirole, have been reported to cause sudden-onset sleep spells in patients with Parkinson disease (PD) while they were driving. The frequency of these spells and whether driving should be restricted has yet to be established. Objective To determine the frequency of and predictors for sudden-onset sleep and, particularly, episodes of falling asleep while driving among patients with PD. Design, Setting, and Participants Prospective survey conducted between January and April 2000 in 18 clinics directed by members of the Canadian Movement Disorders Group; 638 consecutive highly functional PD patients without dementia were enrolled, of whom 420 were currently drivers. Main Outcome Measures Excessive daytime sleepiness and sudden-onset sleep as assessed by the Epworth Sleepiness Scale and the Inappropriate Sleep Composite Score. The latter score, designed for this study, addressed falling asleep in unusual circumstances. The 2 scales were combined in 3 separate formats: dozing off, sudden unexpected sleep, and sudden blank spells. Results Excessive daytime sleepiness was present overall in 327 (51%) of the 638 patients and in 213 (51%) of the 420 drivers. Patients taking a variety of different dopamine agonists had no differences in Epworth sleepiness scores, in the composite score, or in the risk of falling asleep while driving. Sixteen patients (3.8%) had experienced at least 1 episode of sudden onset of sleep while driving (after the diagnosis of PD); in 3 (0.7%), it occurred without warning. The 2 risk factors associated with falling asleep at the wheel were the Epworth Sleepiness Scale score (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.06-1.24) and the Inappropriate Sleep Composite Score (OR, 2.54; 95% CI, 1.76-3.66). A standard Epworth Sleepiness Scale score of 7 or higher predicted 75% of episodes of sleep behind the wheel at a specificity of 50% (exclusion of the question related to driving provided 70% sensitivity and 52% specificity), whereas a score of 1 on the Inappropriate Sleep Composite Score generated a sensitivity of 52% and specificity of 82%. Conclusions Excessive daytime sleepiness is common even in patients with PD who are independent and do not have dementia. Sudden-onset sleep without warning is infrequent. The Epworth score has adequate sensitivity for predicting prior episodes of falling asleep while driving and its specificity can be increased by use of the Inappropriate Sleep Composite Score. It is unknown if routinely performing these assessments could be more effective in predicting future risk for these rare sleep attacks. Patients should be warned not to drive if they doze in unusual circumstances. JAMA. 2002;287:455-463 ...."Funding/Support: Boehringer-Ingelheim (Canada) Ltd provided an unrestricted educational grant for the conduct of this study. Role of the Sponsor: Support for this survey was provided through Boehringer-Ingelheim (Canada) Ltd. This sponsor was approached by one of the authors (A. E. L.) to provide an unrestricted grant to carry out the study. The sponsor assisted in the logistics of developing the study (conference calls between investigators), development of the questionnaire forms, teaching sessions for the study centers (by the authors), and provision of funding (on a per subject basis) to the sites. Data were submitted by the sites to an independent third party where they were keyed into the database and checked. The third party communicated directly with the investigators (not the sponsor) about the data. The sponsor did not have access to the data and did not assist in data analysis." ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn