I'm wide awake, and then I am asleep, no knowledge of the trans-sition. Anyone else experience this?

[gran5-]

When I am driving or out shopping I feel forewarned and hve time to park or lie down, but it isan awful sensation. With my other Dxes I would love to separate out the culprit. (fibromyalgia, sleep apnea,severe degen. disc disease, arrythmia, arthritis, enough, enough. Sometimes sitting here at my keyboard does it, like now I must stop to continue later

[Hikoi]

Hi Gran

I know many people with Parkinson's who experience narcolepsy (suddenly falling asleep) and have had to give up driving, some after an accident. A recent study by UCLA researchers found an association between Parkinson's disease and narcolepsy,

When I first read the title of your blog I realised that is how it is at night for me, i am awake or asleep but none of that nice dreamy in between state.

[wifeofparky in reply to Hikoi]

My husband is the same way. He will be avidly watching a TV program and suddenly is sound asleep then wakes up and wonders why a different show is on. Gotta love PD.

[CJ49]

Is it a side effect from a new drug?

I tried Miirapex once and would fall asleep "mid-sentence" while speaking.

Hope you get help soon.

[PatrickW]

I get this also. Good thing is I feel it coming on but if I stopped every time it happened I would never get anywhere. With that in mind I told my Dr I would only drive around town. When I have to go somewhere I have gotten friends to go or paid kids (that drive) in the neighborhood. Almost every night while I am surfing the TV and I fall asleep but I wake up when the remote hits the floor. This is a problem because I am not giving up my license.... not yet

[Espo]

Hi Gran5,

Consider yourself lucky that you “feel forewarned and have time to park or lie down.” As Hikoi reported, some Parkinsonians don’t get the message until an accident, sometimes a fatal one (Attn: PatrickW – most fatal traffic accidents take place within 25 miles of home, and at speeds of under 40 mph! Did your doctor tell you that when you reported that you “only drive around town.”?). Also, you might want to check out the applicable law where you live/drive. In some jurisdictions, PatickW’s doctor would be legally obliged to report PatrickW’s condition to the DMV (or equivalent law enforcement agency). And before you challenge the moral legitimacy of such “legal obligations to snitch,” consider that not all of these Parkinsonian traffic fatalities were single vehicle, single fatality accidents. Some (predictably!) were multiple vehicle, multiple fatality accidents with the Parkinsonian being responsible for the deaths of innocents. Do you really want such impaired drivers on the highway with your children / grandchildren out there?

[Mast]

My husbands doctor told him that a side effect of the one class of medications for Parkinson's (the one with Mirapex,Requip, and a few others) is the sudden falling asleep.We chose to try the Azilect instead which is not in that same class.

[CJ49]

Azilect is the exact drug I was put on, after trying Mirapex.....I works great and does not cause sleepiness.

PatrickW, ask your doctor for a "different drug." If you "knowingly" have a problem falling asleep while driving,...and cause an accident, (which in that case would be "no accident"), that vehicle you drive is considered a "weapon"....If you hurt, or even worse, "kill" someone.....you may be forced to "take up residence" in a state-run facility. (incarcerated)........Try a different drug.

[PatV]

Hi gran5. Which of these conditions pre-dated the Parkinson's? Is it possible some of them are really a manifestation of PD? I'm always trying to think how to cut back on meds I don't need,

[gran5- in reply to PatV]

Thanks for thinking! I realized that it was around for many years .. I tended to blame my complicated life, work, small kid, school . My friends insisted I had narcolepsy. One thing about sleep, PD seems to demand more than average.

[cabbagecottage]

My husband is the same position .. But hasn't got the energy to ( WHETHER FROM THE PARKINSONSOR HEART CONDITION HE ALSO HAS ).. So I am the one who deals with this complex situation .... He is , at the moment earnestly watching the snooker , but I know when I next look at him he might be sat there with eyes closed , head dropped forward and have sudden (Flinching ( Which might or might not bring him around again ..

For Parkinsons he takes inemet Plus x 4 daily and Sinemet CR 250mg at bedtime.

This is along with 6mg Rotigotine Patches ..

He also takes Forusamide , Bisoprolol, and Ramipril . for his heart .

His mobility is very poor , but we manage apart for the sleep episodes I call it SWITCHING OFF .. . I

It does does to be TRIAL AND ERROR as far as medication .

I am beginniong to think that the patches might be the cause of it .. How do you find out without stopping them ?????????????????

[Moderator_1]

The cause of sleep related problems is complex. It is important that people discuss this with their doctors before thinking about treatment changes. For instance Azilect is a different class of drug to Mirapex (and other dopamine agonists) with a different action in the body. For some people it may not be appropriate to change. Others may find benefit by addiing Azilect to their treatment plan and reducing the amount of agonist they are taking. As the article below points out a variety of medications can contribute to daytime sleepiness as well as changes caused by Parkinson's itself.

What causes excessive daytime sleepiness

in Parkinson’s?

Excessive Daytime Sleepiness (EDS) causes

people with Parkinson’s to fall asleep or doze

frequently during normal waking hours. It can

have several causes:

• Poor sleep at night.

• Sleep disorders such as sleep apnoea (when

unknown to themselves, people seem to

‘stop’ breathing momentarily when asleep,

with symptoms such as loud snoring).

• The use of sleep-producing drugs (such as

sedatives, antidepressants, hypnotics).

• Current evidence suggests that some

dopamine agonists and levodopa may lead

to sleepiness in people with Parkinson’s.

This may be due to a combination of lack

of dopamine in the sleep related centres

of the brain and the effects of the drugs. If

this occurs or if a person with Parkinson’s

experiences a sudden irresistible desire

to sleep during the daytime, then they

need to discuss this with their doctor. In

some situations, drugs which promote

wakefulness, such as selegiline (Eldepryl),

amantadine (Symmetrel) or a specific drug

called modafinil (Provigil) may be used, but

only after specialist approval

.

Anyone experiencing sleepiness should use

caution when carrying out activities such as

driving and operating machinery.

Daytime sleepiness can also occur as a result

of high dose levodopa therapy and stimulant

drugs such as amantadine. These drugs

can have a stimulant effect that can cause

interruption of sleep at night.

Full article may be accessed here : parkinsons.org.uk/pdf/FS30_...

[Hidden]

I have realised that when I knit I fall asleep because the stitches are wrong I

also forget

what I am saying sometimes I am taking Requipe xl and Stalevo

[Carrigan]

My husband fell asleep at the wheel whilst driving and nearly killed us all. He got out of the car at the side of the road and I took over, he has not driven since. It was a great loss to him to stop driving but as he said at least we are all still alive. He does still now occassionally get his bike out and we go on cycle tracks, which has bought him some enjoyment and control back to his life. But again sometimes he is unable to mobilise until his medication kicks in. Oh how frustrating for you all I really admire how you all cope with it all . take care xx

[Zuke]

First point: Nodding off while watching TV is not in the same category as falling asleep at the wheel of an automobile -- but perhaps we can learn to watch for warning signs that we're getting drowsy on the couch and use that knowledge when were behind the wheel.

Second point: Caffeine comes in handy pill form and is very inexpensive. I take it three or four times a day to combat fatigue (and Mirapex).