Evaluating the Efficacy of Nocturnal Continuous Subcutaneous Apomorphine Infusion in Sleep Disorders in Advanced Parkinson's Disease: The APO-NIGHT Study

J Parkinsons Dis. 2016 Oct 19;6(4):787-792. doi: 10.3233/JPD-160886.

Abstract

Background: There are not many data about the beneficial effect of nocturnal continuous subcutaneous apomorphine infusion (NCSAI) over sleep disturbances in advanced Parkinson's disease (PD).

Objective: Evaluate the effect of the NCSAI in sleeping problems and insomnia due to nocturnal hypokinesia inadvanced PD.

Methods: We assessed 17 advanced PD patients with several sleep disturbances measured by SCOPA-SLEEP and PDSS scales. All the patients were on apomorphine infusion during daytime. This therapy was extended to nighttime. We evaluated the patients before the onset and after six weeks with NCSAI.

Results: NCSAI allowed highly significant improvements in SCOPA-SLEEP and PDSS scales (p<0.0001), and daytime somnolence. NCSAI was well tolerated with no major adverse effects were noticed.

Conclusion: This study shows and confirms the efficacy of NCSAI on the sleep disturbances related to advanced PD. We provide an easy protocol to start this therapy.

Keywords: Apomorphine infusion; advanced Parkinson’s disease; nocturnal hypokinesia; sleep disturbances.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Apomorphine / administration & dosage
  • Apomorphine / pharmacology*
  • Dopamine Agonists / administration & dosage
  • Dopamine Agonists / pharmacology*
  • Female
  • Follow-Up Studies
  • Humans
  • Infusions, Subcutaneous
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Parkinson Disease / complications
  • Parkinson Disease / drug therapy*
  • Sleep Wake Disorders / drug therapy*
  • Sleep Wake Disorders / etiology

Substances

  • Dopamine Agonists
  • Apomorphine