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Parkinson's disease - Management
How do I manage daytime hypersomnolence in people with Parkinson's disease?
- Advise people who have sudden onset of sleep without awareness or warning signs not to drive and to consider any occupational hazards.
- Initial management of daytime hypersomnolence depends on its likely cause:
- Anti-parkinsonian medication (such as dopamine agonists):
- Sedating medication (such as antihistamines, antipsychotics, and some antidepressants):
- Reduce, stop, or use an alternative medication; seek specialist advice if necessary.
- Inadequate rest at night:
- Dementia.
- Consider requesting advice from, or an interim referral to, the person's Parkinson's disease specialist team, so that:
- Medication that could be causing or contributing to daytime hypersomnolence can be reduced or stopped.
- Modafinil can be considered for daytime hypersomnolence (off-licence use). However:
- Modafinil is contraindicated in people with uncontrolled moderate to severe hypertension, and in people with arrhythmias.
- Modafinil is associated with skin and subcutaneous tissue reactions, and with the development of neuropsychiatric disorders.
In depth
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