[lou_lou]

Originally Posted by kariner

Hello,

Again an article of yesterday's harvest

Greetings
Karine

1: Curr Neurol Neurosci Rep. 2006 Mar;6(2):169-76. Links
Excessive daytime sleepiness and unintended sleep in Parkinson's disease.
Rye DB.
Department of Neurology, Emory University School of Medicine, 101 Woodruff Circle, WMRB-Suite 6000, PO Drawer V, Atlanta, GA 30322, USA. drye@emory.edu

Patients with Parkinson's disease and parkinsonian syndromes (eg, dementia with Lewy body disease, multisystem atrophy, and Shy-Drager syndrome) suffer from daytime sleepiness. This sleepiness is common and very real, often approaching levels observed in the prototypical disorder of sudden-onset sleep, namely narcolepsy/cataplexy. Physicians need to be vigilant in assessing parkinsonian patients for sleepiness because treatment can dramatically enhance quality of life and prevent the significant morbidity and mortality that attends daytime sleepiness. Male patients with advanced disease, cognitive impairment, drug-induced psychosis, and orthostatic hypotension are most at risk for developing pathologic sleepiness. Because primary sleep disorders can coexist with parkinsonism (eg, sleep apnea, insufficient or interrupted sleep), these potential causes should be carefully assessed with polysomnography and treated appropriately. Dopaminomimetics exacerbate sleepiness in a small subset of patients in a dose-dependent fashion. Nonetheless, the primary pathologies involved in parkinsonism appear to be the greatest contributors to daytime sleepiness. Sleepiness in parkinsonism, especially a narcolepsy-like phenotype, may necessitate treatment with wake-promoting agents such as bupropion, modafinil, or traditional psychostimulants.

PMID: 16522272 [PubMed - indexed for MEDLINE]

Dear Karine,
Thank you for all your research, I have had PD for over 10 years dxd,
I am 43 years old - and when I awake,sometimes its very hard to breath
and I have insta -panic!
I did not mean to put you to work, but I am very grateful for the great info!
in 2000
We made a film - called "In Search of A Champion" -
Congressman Evans and Greg Gerhardt and I gave a copy to then
President Clinton at the White House.
Congressman Evans of Illinois - a 22 veteran of the Congress of the US,
has had to retire, unfortunately - and Dr. Greg Gerhardt has been fighting for the GDNF serum to continue -w/ Amgen as controller.
I am just a PD patient/advocate for cures, waiting impatiently?
if you have the time my friend periwinkle has put it online:
it won many awards ~ take care!
link -
www.pwnkle.com/champion.htm

[kariner]

Hello,

Thanks for the link! I will have Anne have a look at this (haven't seen the film yet, it is loading while I write). You are fighting for exactly the same cause!!! I felt I had to tell you right away. It is one of the subjects she often writes about, young-onset PD (and, even, very young, sometimes...)

Don't worry to put me to work, it is for my own formation, you know.

See you (I'll give you my impression if I manage to see the film)
Karine

[kariner]

PS

"Don't worry to put me to work, it is for my own formation, you know." You didn't - I volunteered.

Karine

[kariner]

Hello,

I have seen the films. I am not yet familiar with Mozilla Firefox settings so I watched it with IE - a clue for those who can't open it with Mozilla Firefox.
Well done!

When do your waking up in panic with a choking feeling occur? May I ask you to describe it? Don't though take anything I say for set in stone - but you know that. Of course the only way to know if you have apnea is to undergo a polysomnography - or have someone tell you if you stop breathing, but there, too, the necessary next step will be to check in for proper examination.

See you
Karine

[kariner]

Hi again,

I found this (see attached file) on the Net : the Handbook of sleep and PD. Interresting! It was a PDF but too big so I put it into word and zipped it.

[attach]SLEEP DIFFICULTIES.zip[/attach]

See you
Karine

[kariner]

Prevalence of Sleep Disturbances Varies According to Parkinson's Disease Subtype: Presented at ENS

By Norra MacReady

LAUSANNE, SWITZERLAND -- June 1, 2006 -- People with the akinetic-rigid subtype Parkinson's disease (PD) have an especially high risk of sleep disturbances, according to preliminary findings from a study presented here at the 16th Annual Meeting of the European Neurological Society (ENS).

Sleep disorders are commonly associated with PD, said Natasa Klepac, MD, professor of neurology, University of Zagreb Medical School, Zagreb, Croatia. In these patients, sleep disorders have several causes, including neurodegenerative changes that affect sleep centers in the brain, and the persistence of PD symptoms at night that make sleeping difficult, she said during a poster session on May 31st.

Dr. Klepac and her colleague, Maja Relaj, MD, professor of neurology, University of Zagreb Medical School, conducted a study to determine whether there is a difference in the incidence and type of sleep problems according to PD subtype.

They studied a consecutive series of 44 women and 39 men with idiopathic PD. The cohort's mean age was 61 years, they had a mean PD duration of 5 years, and a mean Hoehn & Yahr disease stage of 2, which is indicative of bilateral symptoms and affected gait and posture, but minimal disability.

Patients' motor performance was evaluated using the motor section of the Unified Parkinson's Disease Rating Scale, which gives a score according to tremor to bradykinesia ratio (TBR). This score was then used to classify patients as akinetic-rigid or tremor-dominant. Tremor-dominant patients were defined as those with TBR of 0.5 or more, while the akinetic-rigid types had a TBR less than 0.5.

Insomnia severity over a 1-month was assessed using patient self-reports on the Pittsburgh Sleep Quality Index (PSQI), which uses a higher score to denote poorer quality of sleep. Daytime sleepiness was measured with the Epworth Sleepiness Scale (ESS). An ESS score a score of 10 or more suggests that the person may not be getting enough sleep, and a score of 18 or more is considered very sleepy.

Results showed that 54 (65%) of the patients had the akinetic-rigid subtype and 29 (35%) had tremor-dominant PD. The mean PSQI score among the akinetic-rigid patients was 14, and among the tremor-dominant patients it was 9 (P <.05). The akinetic-rigid patients had worse scores in the quality, duration, and latency of sleep, as well as sleep disturbances. There was no significant difference between the groups on the ESS scores.

Nocturnal immobility among patients with the akinetic-rigid subtype of PD may interfere with normal sleep patterns, Dr. Klepac said. She suggested that clinicians maintain a particularly high index of suspicion for sleep disturbances among patients with this form of Parkinson's disease.


[Presentation title: Sleep and Parkinson's Disease: Preliminary Results. Poster 557]

Source
http://www.docguide.com/news/content...257180006BCF6D