Unawareness of naps in Parkinson’s disease and in disorders with excessive daytime sleepiness

Sudden episodes of falling asleep while driving occur in patients with PD treated with dopamine agonists or levodopa.1 However, one may not adequately perceive the wake-sleep transition at sleep onset2 or when awakening from a sleep episode. We examine whether patients with and without PD who fall asleep during daytime naps realize afterward that they have been asleep. Forty-seven somnolent patients with PD (table) were being treated with levodopa (all patients) and dopamine agonists (23 patients) and were free of other sedative drugs. They underwent a daytime multiple sleep latency test with five nap opportunities.3 After each nap, they had to state if they had slept or dozed. Those who slept during a test and firmly answered they did not were considered as misperceiving daytime sleepiness. Their responses were compared with those of 51 patients with sleep disorders (mainly hypersomnia …