Sleep-wake cycle and effects of cabergoline monotherapy in de novo Parkinson's disease patients: An ambulatory polysomnographic study

Objective: To investigatethe sleep-wake cycle and theeffects of cabergoline monotherapyin a homogenous group of de novoParkinson's Disease (PD) patientswithout confounding comorbidfactors. Design and participants: Twelve de novo patients affected byidiopathic PD underwent twoambulatory polysomnographic (APSG)monitoring sessions. The firstwas performed at baseline, and thesecond recording one-month afterstable treatment with cabergolinemonotherapy. Subjective daytimesleepiness was evaluated by meansof the Epworth Sleepiness Scale.Data obtained in PD patients atbaseline were compared with thoseobtained in 12 age- and sexmatchedhealthy subjects. Results: Diurnal sleep parameters did notshow significant differencesbetween controls and PD patientsat baseline. In PD patients, nosignificant changes in diurnal sleepwere observed between baselineand cabergoline treatment. Regardingnocturnal sleep, patients atbaseline showed a significantlylower sleep efficiency and a significantlyhigher Wakefulness AfterSleep Onset than controls. Withrespect to baseline, a significantincrease in REM latency and asignificant reduction in REM sleepwere observed during cabergolinetreatment. Conclusions: In the earlystage of PD, the neurodegenerativeprocess does not seem to be directlyresponsible for daytimesomnolence, but it may be directlyinvolved in the alteration of nocturnalsleep. Cabergoline monotherapydoes not affect daytimesleep propensity and, despite clinicalimprovement, it may have negativeeffects on REM sleep.