People With Early Parkinson’s Report Hallucinations, Sleepiness

Parkinsons Disease People with early Parkinson’s disease report a higher than anticipated development or worsening of hallucinations, sleepiness, and swelling.

Researchers have identified factors that make people more likely to develop these problems, according to a study published in the July 10, 2007, issue of Neurology®, the medical journal of the American Academy of Neurology.

"By identifying risk factors, it may help guide treatment decisions, allow for early intervention and possibly reduce disability," said study author Kevin Biglan, MD, MPH, with University of Rochester School of Medicine in Rochester, NY, and member of the American Academy of Neurology.

For the study, researchers reviewed the results of a four-year clinical trial involving 301 people with an average age of 61 who had early Parkinson’s disease. Half of the group received the drug levodopa; the other half took pramipexole. No one reported having hallucinations at the beginning of the study.

The study found nearly one-fifth developed hallucinations, more than one-third of the participants developed sleepiness, and nearly half developed swelling within four years of starting treatment. Multiple health problems, along with age, gender, initial type of treatment and cognitive status were identified as risk factors.

People suffering from Parkinson’s disease have severe damage to the same cell group of neurons called hypocretin. Loss of hypocretin causes narcolepsy. The person may face day time sleepiness that resembles narcoleptic attacks.

Patients often have trouble staying awake during the day. This is because they have trouble sleeping during the night because of medications prescribed for Parkinson’s treatment. People fall into REM sleep more quickly than normal person, according to their brain activity.

These symptoms are related to narcolepsy. But daytime sleepiness in patients with Parkinson’s can be successfully treated with drugs that are used for narcolepsy. Daytime sleepiness increases as Parkinson’s disease progresses. [Narcolepsy and Parkinson's Disease]

If you take dopamine agonist instead of levodopa early on, your symptoms may improve. You will not get side effects that people get if they take levodopa for longer periods.

Half of the people get problems with levodopa. Side effects can be uncontrollable movements or the medicine works for a shorter time.

Dopamine agonists relieve symptoms such as shaking, stiff muscles and slow movement. With fewer symptoms, you can delay the taking of levodopa or use less levodopa.

If you take dopamine agonist with levodopa, your symptoms may not be as bad when your levodopa dose starts to wear off.

Using stimulants and alerting medications, sleep attacks can be prevented. It also helps the patients to avoid excess napping, which contributes to insomnia.

In addition to drugs, behavioral therapy should be used for sleep and sleepiness problems in Parkinson’s patients.

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