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  1. Dr. Okun, I am 7.5 years post-diagnosis. I've had bad reactions to all agonists so have been on carb/levo followed by the Duopa pump since 11/2015 with very good symptom control and minimal dyskinesia. For the past nine months I've noticed I am startled by movements that used to not bother me. For example, I have difficulty using my walker to go down a sidewalk ramp. I have to use the brakes to feel safe. I am sensitive to riding in a car and react with tightened muscles to every possible traffic danger. The past month I've been awakened from sleep by my body jerking as if I have just experienced an electrical shock, as much as three to four times a night. It also happens when I nap during the day. Could this be disease connected or Duopa related? It happens while the Duopa is running and when it's completely turned off for the night. Lastly, I had a hospitalization with an infection at the g-j tube site three weeks ago. While I was there my oxygen sats ran consistently in the upper 80s at night and low 90s during the day. I was kept on oxygen 24/7 the first two days, and only at night after that. Could low oxygen cause the nighttime jerking? As always, I am grateful for any insight you can offer. Beau's Mom (Dianne).