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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with interest the recent article by Avorn et al.¹ Sudden onset of somnolence/sleep (SOS) is an important clinical problem in Parkinson disease (PD) and remains an area of significant controversy. This study identifies dopamine agonists as increasing the risk of SOS in a large sample of tertiary care PD patients. The findings of the study are interesting and confirm previous reports of a higher risk of SOS associated with dopamine agonist therapy relative to levodopa and other antiparkinsonian drugs.^2-3

The mean Hoehn and Yahr (H&Y) scores reported in Table 3 of the article, however, are not consistent with early- to mid-stage PD as would be expected for the disease durations reported (1.2-4.9 years).⁴ The H&Y staging of disease was apparently assessed by the referring neurologists and the average H&Y score was a minimum of 3.6 (dopamine agonists only) up to a maximum of 4.7 (levodopa + dopamine agonist . . . [Full Text of this Article]

AUTHOR INFORMATION

John C. Morgan, MD, PhD; Kapil D. Sethi, MD, FRCP(UK)

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