1. Clonazepam or Levodopa? Which medication provides the most uneventful delta sleep in patients with Periodic Limb Movement Disorder Daniel J. Waclawski, Department of Biology, York College  Periodic Limb movement disorder(PLM) is a sleep disorder in which the patient involuntarily moves his/hers legs or arms during sleep. excessive day time sleepiness, insomnia,  Can cause: excessive day time sleepiness, insomnia, severe pain in the effected limbs, disruption in daytime activates, highly fragmented sleep, decrease in slow-wave sleep.  No definite cause has been found, but, studies suggest a genetic link. genetic link. Clonazepam: - From the benzodiazepine family of drugs - Is the most commonly prescribed medication for PLM patients -Has shown to effectively suppress arousals from sleep but does not greatly reduce limb movements -Adverse effects: dependency on drug may develop, followed by withdrawal symptoms Levodopa - Is a dopamine agent -Is the second most commonly prescribed medication for PLM patients -Has shown to effectively suppress limb movements but not sleep arousals - Adverse effects: hypotension, hair loss, visual and auditory hallucinations, and heighten anxiety Objectives ObjectivesObjectives Introduction 1) To find out which of the two most widely prescribed drugs for PLM provides the most uneventful or “restful” delta sleep in PLM patients. Clonazepam or Levodopa? 2) Uneventful delta sleep is defined in this study as: which mediation gave the lowest average movements, EP scores, and the longest, uninterrupted, Delta sleep(in terms of duration) in PLM patients Methods  Eliminated confounding variables through a thorough search of patient’s medical history to ensure that applicants are very similar, as in: lifestyles, weight, disease history, family history…etc. Data was collected through past studies And current studies. Medical record search/pick applicants Assign patients to groups and run Sleep studies Obtain Limb Movement, Ep score,and Duration numbers, and Record them into Lab book Run appropriate Statistical tests on data Collected and draw conclusions  Patients divided into three groups: -1. non-medicated - 2. Clonazepam group - 3. Levodopa group  EP score measures sleep deprivation. Score is collected through post-study survey done by patients. Data Collection  Average # of limb movements during the two stages recorded for each sample taken.  EP scores were recorded from each sample.  Duration of delta sleep(in minutes) from each sample was recorded.  600 cumulative samples taken. 200 samples for each group. Results Conclusions (1) Results show that Clonazepam patients experienced the least amount of movements in delta sleep. Followed by Levodopa, then control group (2) Patients from the Clonazepam group had the Small mean Ep scores, followed By Levodopa group, then control. (3) Clonazepam patients had the highest duration of delta sleep, the control group had the shortest average duration, Levodopa’s mean duration of delta sleep fell in between the two. (4) All of the previously mentioned conclusion statements point to Clonazepam as the medication that gives the most “restful” sleep in PLM patients in regards to # of movements, Ep scores, and duration of delta sleep. Acknowledgements I would like to thank Dr Rehnberg for his guidance throughout the senior thesis process. Thank my mother for Introducing me to the project. Many thanks to the unwavering support from my father, sister and two amigos Chris and Ernie. Literature Cited Pollmacher, Thomas, and Schulz, Hartmut. Periodic leg movements(PLM): their relationship to sleep stages. Sleep. [serial online] 16(6): 572-577. Available from: www.journalsleep.org www.journalsleep.org Winkelman, John. The evoked heart rate response to Periodic Leg movements of sleep. Sleep. [serial online] 22: 575-580. Available from: www.journalsleep.org www.journalsleep.org