Abstract
Patients with medical disorders often express complaints about sleep quality and length. Hence it is not surprising that in medical illness and with medications for chronic disease, there might occur alterations in sleep architecture, sleep continuity, and sleep organization. One major issue here is the causality and impact of the sleep disorder on any given medical disorder.
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There are two dopamine agonists available. Pramipexole is dependent on renal excretion and ropinirole dependent on hepatic metabolism. They act on D2, D3, and D4 receptors. Since there is a circadian rhythm for the symptoms of RLS, it is important to know the timing of the patient’s symptoms. The agent should be given 30–45 min prior to the patient’s onset of symptoms and may require a second dose at bedtime. For those patients who have symptoms very early in the day, long-acting dopamine agonist may be required. The most common side effects include nausea, dyspepsia, sudden sleepiness, or even insomnia. Care must be taken in prescribing this class of agent in elderly patients due to the risk of orthostatic hypotension. A more rare complication, but one for which there must be counseling, is that of compulsive behavior such as pathological gambling, shopping, or hypersexuality.
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Lance, C.G., Ibrahim, L., Kelley, D. (2014). Sleep in Medical Disorders. In: Competencies in Sleep Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9065-4_16
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DOI: https://doi.org/10.1007/978-1-4614-9065-4_16
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