Excessive Daytime Sleepiness

Sleepiness during the day is seen in about 30-50% of patients with PD and it is more prominent as the disease advances. Daytime sleepiness may arise in patients with PD for many reasons including:

  • Poor night’s sleep
  • Dopaminergic medications, especially dopamine agonists (Mirapex and Requip) may cause daytime sleepiness.

Did you know dopaminergic medications like Requip can cause sudden "sleep attacks" while driving, which is a potential cause of motor vehicle accidents?

How is daytime sleepiness treated?

You may have to make certain lifestyle modifications such as:

  • Establish good sleep hygiene, which includes a set bedtime and wake-up time.
  • Get exposure to adequate light during the day and darkness at night.
  • Indoor lighting may not be sufficient to promote a normal circadian rhythm.
  • Avoid sedentary activities during the day.
  • Participate in activities outside the home, as they may be helpful in providing stimulation to prevent daytime dozing.
  • Get physical exercise appropriate to your level of functioning, which may also promote daytime wakefulness.
  • Strenuous exercise, however, should be avoided for 3 to 4 hours before sleep.
  • Patients with excessive daytime sleepiness should be warned not to drive while sleepy. The occurrence of motor vehicle accidents is increased during periods of drowsiness and may be associated with sudden onset of sleep (sleep attacks).
  • If you are on a dopamine agonist and you experience daytime sleepiness or sleep attacks you will need to talk to your doctor about possibly decreasing the dose.
  • You might also want to decrease your intake of stimulants like caffeine, modafinil (Provigil) and methylphenidate (Ritalin). Talk to your doctor before making any major lifestyle modifications.

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Medical content reviewed by: Nina Browner, MD—Medical Director of the NPF Center of Excellence at the University of North Carolina at Chapel Hill in North Carolina and by Fernando Pagan, MD—Medical Director of the NPF Center of Excellence at Georgetown University Hospital in Washington, D.C.

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