Table 9.

Causes of excessive daytime sleepiness in PD

Age-related changes in sleep architecture and alterations in circadian rhythm
PD-related disturbance in sleep–wake regulation
Disturbed nocturnal sleep as a result of
PD-related motor symptoms (akinesia/bradykinesia, tremor, rigidity)
Parasomnias with vivid dreams, nightmares, hallucinations
Sleep disorders, such as RLS, RBD, sleep apnea
Coexisting medical and psychiatric conditions, such as urinary frequency and depression
Medications that can cause sedation
Dopaminergic drugs (dopamine agonists, levodopa, selegiline)
Other antiparkinsonian agents (anticholinergics, amantadine)
Benzodiazepines, antidepressants, neuroleptics, and anxiolytics
Endocrine dysfunction, such as hypothyroidism