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To the Editor: Dr Hobson and colleagues¹ confirmed our preliminary finding² that episodes of sudden sleep are rare in patients with Parkinson disease (PD). They reported that 16 of 420 patients reported sudden-onset sleep while driving. Three patients did not experience prodromal drowsiness or warning, and 2 events put drivers at risk. These numbers are similar to our estimate of an annual event incidence of 2%.

In her Editorial,³ Dr Comella offers several criticisms of our initial study.⁴ She incorrectly states that we reported a "unique" association between events of sudden sleep and the treatment of PD with the new dopamine agonists pramipexole and ropinirole. In fact, we reported these events in patients who received pramipexole only because we observed them. If we had encountered similar cases in patients with PD treated with other dopamine agonists or with levodopa, we would have reported them as well. We were struck by . . . [Full Text of this Article]

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