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Compared with the elderly healthy subjects,patients with PD have an elevated nocturnal activity level and an increased proportion of time with movement,indicating a more disturbed sleep.The mean duration of nocturnal immobility periods was similar for both groups.This measure,however,did reflect the self-reported disturbed sleep maintenance in both groups.The daily dose of levodopa or the use of dopamine agonists in patients not receiving levodopa,rather than disease severity,proved to be the best predictors of nocturnal activity.We hypothesize that in mildly to moderately affected patients with PD,levodopa or dopamine agonists cause sleep disruption by their effects on sleep regulation.In more severely affected patients,the beneficial effects of these drugs on nocturnal disabilities that cause sleep disruption in PD prevail. |
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