Sunday, August 7, 2022

Does Parkinson’s Affect Sleep

Potentials Ways To Reduce Fatigue

How does Parkinson’s effect sleep?
  • Exercise. It may seem counterintuitive get moving if youre feeling fatigued however, the right kind and the right amount of exercise can significantly reduce fatigue. Experiment. Sometimes just getting out the door for a walk in the fresh air can reduce fatigue.
  • Talk to your doctor if you think you may be depressed. Its possible that an anti-depressant could reduce fatigue.
  • Plan your time. Identify when you tend to have the most energy throughout the day and plan to get your most important jobs done then.
  • Be realistic, but still do something. If youre feeling extra exhausted on a certain day, dont put pressure on yourself to accomplish everything you planned. Do somethingbecause accomplishing something will give you an energy boost but be realistic about what youre capable of doing.
  • Delegate. Its not easy. You may have concerns about being a burden to others. Most people will be thrilled to help. Let them.
  • Organize and declutter. Opening up spacephysically, emotionally, mentally and logisticallycan help you reduce stress and as a result reduce feelings of fatigue.
  • Connect with others. We know that when you feel wiped out that the last thing you want to do is attend a support group meeting or event, but connecting with others in a positive way has the potential to not only make you feel supported and encouraged and loved, but it may very well give you the exact bump in energy that you need.

Rem Sleep Behavior Disorder With Parkinsons Disease Can Be A Nightmare

Acting out dreams could indicate REM sleep behavior disorder. What you should know about the symptoms, diagnosis and treatment.

Certain sleep disorders are common in people with Parkinsons disease.

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One of them REM sleep behavior disorder is a condition characterized by the acting out of dreams that are vivid, intense and violent. People have been known to yell or talk while asleep, carry on conversations or hit themselves or their bed partner. Even if physical damage does not occur, the condition can be frightening for the bed partner to witness.

REM behavior disorder does not necessarily disrupt the quality or quantity of sleep itself. But it is potentially harmful because of the physical movements involved.

Medication Not Working The Way It Used To

In the early stages, taking medicine works well to get rid of symptoms. But as Parkinsons progresses, your medication works for shorter periods of time, and symptoms return more easily. Your doctor will need to change your prescription.

Dr. Valerie Rundle-Gonzalez, a Texas-based neurologist, says to pay attention to how long your medicine takes to kick in and when it stops working. She says you should feel like symptoms significantly improve or are almost gone while on medication.

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Parkinsons Disease Is A Progressive Disorder

Parkinsons Disease is a progressive neurodegenerative disorder that primarily affects movement and, in some cases, cognition. Individuals with PD may have a slightly shorter life span compared to healthy individuals of the same age group. According to the Michael J. Fox Foundation for Parkinsons Research, patients usually begin developing Parkinsons symptoms around age 60 and many live between 10 and 20 years after being diagnosed. However, a patients age and general health status at onset factor into the accuracy of this estimate. Age is the greatest risk factor for this condition, but young-onset Parkinsons disease, which affects people before age 50, accounts for between 10 and 20 percent of PD cases.

While there is no cure for Parkinsons disease, many patients are only mildly affected and need no treatment for several years after their initial diagnosis. However, PD is both chronic, meaning it persists over a long period of time, and progressive, meaning its symptoms grow worse over time. This progression occurs more quickly in some people than in others.

Pharmaceuticals and surgical interventions can help manage some of the symptoms, like bradykinesia , rigidity or tremor , but not much can be done to slow the overall progression of the disease. Over time, shaking, which affects most PD patients, may begin to interfere with activities of daily living and ones quality of life.

What Does Osa Look Like

Know About Parkinson

OSA is a sleep breathing disorder with several identifiable risk factors. Sleeping partners may have witnessed their loved ones choking or gasping for air in their sleep. Also, snoringthough not proof alone of OSAis still suspect if its loud and frequent.

OSA is identified as pauses of breathing during sleep which last at least 10 seconds each and which occur five times or more per hour, on average, during a full nights sleep. By comparison, healthy people without OSA experience less than three episodes of breathing pauses per hour per night.

When these pauses occur, a flurry of other processes within the body take flight: higher blood pressure and pulse, the release of stress hormones, and shifts in insulin-glucose ratios.

When experienced repeatedly over the long-term, but left untreated, OSA is a leading cause for many chronic health issues, including cardiovascular disease, hypertension, type 2 diabetes, major depression, and anxiety disorder. Untreated OSA is also a significant cause of motor vehicle accidents and dangerous mistakes and errors that occur during the day as a result of lingering daytime sleepiness.

Other classic symptoms include frequent nocturnal awakenings, and a variety of sensations upon awakening, such as shortness of breath, sore throat, dry mouth, and headache.

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Potential Ways To Reduce Excessive Daytime Sleepiness

  • Assess the underlying cause
  • Improve nocturnal sleep through medications, cognitive behavioral therapy, diet, light therapy and more
  • Evaluate all medicines being takensome have hypersomnia as a side effectand adjust as needed
  • If taking dopaminergic medications, consider dose adjustment
  • Watch consumption of alcohol or sleep-inducing foods/ingredients
  • Experiment with caffeine

How Is Daytime Sleepiness Treated

Consider making certain lifestyle modifications, such as:

  • Establish good sleep hygiene, including a set bedtime and wake-up time.
  • Get exposure to adequate light during the day and darkness at night.
  • Remember indoor lighting may not be sufficient to promote a normal circadian rhythm.
  • Avoid sedentary activities during the day.
  • Participate in activities outside the home. They may help provide stimulation to prevent daytime dozing.
  • Get physical exercise appropriate to your level of functioning, which may also promote daytime wakefulness. Strenuous exercise, however, should be avoided six hours before sleep.
  • Do NOT drive while sleepy if you experience excessive daytime sleepiness. Motor vehicle accidents increase during periods of drowsiness and may be associated with sudden onset of sleep .
  • Talk to your doctor about possibly decreasing the dosage of dopamine agonists if you experience daytime sleepiness or sleep attacks.
  • Talk to your doctor about decreasing stimulants like caffeine, modafinil and methylphenidate .

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Nighttime Hallucinations Psychosis & Confusion

Nighttime hallucinations and confusion may result from any combination of cognitive impairment, dopaminergic medications, age and PD-related vision changes and lack of sleep. Psychosis may first appear after infection, trauma, surgery or prolonged hospitalization. Symptoms may range from a sensation that someone or something is standing at the side of or behind the person, to very detailed and often frightening visions. Delusions may occur as well.

Treating Parkinsons Psychosis

The first-line approach to treatment of PD psychosis involves simplification of the anti-PD medication regimen and adjusting dose timing , treating other sleep disturbances, providing a consistent and familiar sleep environment , and in more severe cases, the use of atypical antipsychotic drugs.

Most of the available anti-psychotics are always avoided in PD psychosis because they block dopamine receptors and can cause significant problems with movement. However, two anti-psychotic medications, quetiapine and clozapine, are sometimes used as they have less of an ability to worsen motor symptoms. However, data for the use of quetiapine is limited and clozapine requires the patient to undergo frequent blood draws to monitor blood counts. A newer medication pimavanserin, was approved by the FDA to treat PD psychosis. It has a different mechanism of action, and does not block the dopamine system, but rather the serotonin system, and therefore does not increase motor symptoms.

How Does Parkinson Affect The Nervous System

Can Parkinson’s disease affect a person’s mood, behaviors or sleep?

What Is Parkinsons?Parkinsons Effect On The Nervous System And Dopamine.The Two Types Of Parkinsons Related To The Nervous Systemdistinct subtypesAutonomic Nervous System And Parkinsons

  • Breathing.
  • Blood pressure.
  • Heart rate.
  • How To Keep Your Nervous System Healthy?Here are some important recommendations:

  • You should always monitor your eating routine to maintain the glucose neurons use for energy.
  • Make sure to keep up a balanced diet with some healthy fats. Your diet should include good levels of B-12 and D vitamins.
  • Avoid drinking excessive alcohol as well as smoking.
  • Maintain a solid sleep schedule .
  • Keep your brain active through playing mind games and writing by hand.
  • Always try to maintain a healthy weight.
  • Avoid chronic stress activities that require repetitive motion.
  • Make sure to adjust your spine regularly by a chiropractor.
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    Treatment Of Excessive Daytime Sleepiness In Pd

    The first step in the treatment of EDS should be the correction of underlying conditions . For example, it may be useful to treat the conditions that disturb sleep quality at night or to arrange medications that cause daytime sleep episodes. After that, pharmacological treatment options for EDS should be considered. Nonpharmacological treatment approaches can be performed in the treatment of mild to moderate EDS cases . Modafinil is widely used for the symptomatic treatment of EDS, which appears to stimulate catecholamine production . Common side effects of modafinil are insomnia, headache, dry mouth, dizziness, nausea, nervousness, and depression . A review has reported that sodium oxybate and methylphenidate have inadequate evidence that they are effective in the treatment of EDS in PD . Amantadine and selegiline are reported to have an alerting effect . Thus, amantadine and selegiline may be preferentially used in PD patients with EDS.

    Sleep And Depression In Parkinson’s Disease

    Depression is seen in approximately 40% of PD patients in the course of their disease. Most persons with depression, including PD patients, also will experience problems with sleep. In depression, sleep does not refresh you like it used to, or you wake up too early in the morning. Dreams for depressed people are different, too–they are rare and often depict a single image.

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    Why Do Parkinsons Patients Sleep So Much

    Parkinson’s patients experience difficulties with their sleep due to the disease itself and the medications that treat it. This can lead to increased sleepiness during the day.

    Parkinsons disease can cause problems with sleep, and the medications used to treat it can cause even more. Difficulties sleeping during the night can cause daytime sleepiness, and the medications can also cause drowsiness. This disruption to the circadian rhythms can lead to more frequent, lower quality sleep.

    How Are Sleep Problems Treated In People With Parkinsons Disease

    Parkinson

    Your provider will recommend treatments that address whats causing your sleeping challenges. Your provider may:

    • Change your medication: If a medication could be causing your sleep issues, your provider may decide to adjust your treatment plan. Reducing the dose or switching medicines may solve the problem.
    • Prescribe a new medication or therapy: If you have a sleep disorder, your provider will discuss your options. In some cases, your provider may recommend a new medication. If you have sleep apnea, wearing a special oral appliance can help. The device enables you to get a steady flow of oxygen, so your body doesnt gasp for air.
    • Suggest lifestyle changes: Your daily habits and sleeping environment can help or hurt your sleep efforts. Setting regular sleep and wake times, keeping the room dark and avoiding electronic screens at bedtime may improve how well you sleep. If you have REM sleep disorder, your provider will discuss options for how best to protect you while you sleep.

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    Tips For Better Sleep

    • Keep a regular sleep schedule go to bed at the same time and get up at the same time.
    • Choose your bedtime based on when you want to get up. Plan to spend seven to eight hours a night in bed.
    • Make a bedtime routine for example, snack, bath, tooth-brushing, toileting and follow it every evening.
    • Spend time outdoors and exercise every day, in the morning if possible. Avoid exercise after 8:00 p.m.
    • If you cant get outdoors, consider light therapy sitting or working near a light therapy box, available at drug stores and department stores.
    • If you nap, try to do so at the same time every day, for no more than an hour, and not after 3:00 p.m.
    • Sleep in a cool dark place and use the bed only for sleeping and sexual activity.
    • Do not read or watch television in bed.
    • Use satin sheets and pajamas to make moving in bed easier.
    • Minimize drinking liquids for three hours before bedtime to avoid frequent nighttime urination.
    • Go to the bathroom immediately before retiring.
    • Place a commode next to the bed, to minimize the effort, and light to get up during the night.
    • Avoid:
    • Alcohol, caffeine and other stimulants such as nicotine
    • Heavy late-night meals
    • Heavy exercise within six hours of bedtime
    • Thoughts or discussions before bedtime about topics that cause anxiety, anger or frustration
    • Clock watching
    • Screen time television, phones, tablets one or two hours before bed.

    Sleep Disorders In Parkinson’s Disease By Amer G Aboukasm

    Although the daytime clinical manifestation of Parkinson’s disease have been well recognized for almost two centuries, the nocturnal symptoms, which occur in as many as 75% of patients and the associated sleep disorders were not studied until the 1960s. A variety of psychological and physiological processes can lead to disruption of the normal rhythm of the sleep-wake cycle in patients with Parkinsonism. First, the degenerative process in Parkinson’s disease affects the neurophysiological and neurochemical systems responsible for sleep organization, thus results in disruption of sleep. Second, the motor, respiratory and behavioral phenomena accompanying the disease may produce nocturnal symptoms. Third, the medication used in its treatment may induce new symptoms, such as nightmares or nocturnal movements. All these effects on sleep have implications for treatment planning.

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    The Effect Of Exercise

    Exercise has been shown to have a variety of beneficial impacts, and sleep is no exception. In fact, a study found that after four months of physical activity, adult insomniacs got an average of one extra hour of sleep per night. Exercise improves sleep quality, quantity, number of nighttime waking incidents and the time it takes to fall asleep. Sleep also gives you more energy and therefore contributes to a positive feedback loop of more exercise and more sleep.

    From preventing against cancer to improving your learning capabilities to making cool-headed decisions, consistent and proper sleep habits can offer a wide range of positive effects. But even if you know how important sleep is, when youre having trouble sleeping, what can you do to fix it?

    The number of reported cases of sleep issues has increased dramatically in recent years. There are a variety of underlying causes, as Walker describes:

    To date, we have discovered numerous triggers that cause sleep difficulties, including psychological, physical, medical, and environmental factors . External factors that cause poor sleep, such as too much bright light at night, the wrong ambient room temperature, caffeine, tobacco, and alcohol consumption can masquerade as insomnia. -Matthew Walker, 243

    Changes In Sleeping Patterns

    Sleep Problems and Parkinson’s Disease

    As Parkinsons progresses, you can also develop problems with sleep patterns. These may not happen in the early stages, but can be noticeable later. You might wake up often in the middle of the night or sleep more during the day than you do at night.

    Another common sleep disturbance for people with Parkinsons is rapid eye movement sleep behavior disorder. This is when you start acting out your dreams in your sleep, such as verbally and physically, which can get uncomfortable if someone is sharing your bed. Dr. Rundle-Gonzalez says many times a bed partner will be the one to notice sleep problems.

    REM sleep behavior disorder can also happen in people who dont have Parkinsons. However, if this isnt something youve dealt with before, its likely related to your disease. There are medications your doctor can prescribe to help you sleep comfortably through the night.

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    Why Do Parkinsons Patients Have Trouble Sleeping

    Despite having daytime tremors, Parkinsons patients do not shake in their sleep. However, both Parkinsons disease itself and the medications used to treat it can give rise to a number of sleep problems that lead to insomnia and excessive daytime sleepiness.

    Patients with motor symptoms may have trouble adjusting sleeping positions to get comfortable. Others may experience distressing nocturnal hallucinations when trying to fall asleep. These may be a result of medications or cognitive impairment.

    In turn, excessive daytime sleepiness may occur as a consequence of sleeping poorly at night. It may also be triggered by medications. Parkinsons patients who suffer from EDS may be at a higher risk of accidents and unable to safely carry out activities such as operating a motor vehicle.

    Since insomnia frequently goes hand-in-hand with anxiety and depression, it may be a contributing factor to sleep problems in people with Parkinsons disease. For that reason, doctors often look for mental health disorders in people with Parkinsons disease who have sleep problems.

    What Are The Primary Motor Symptoms Of Parkinsons Disease

    There are four primary motor symptoms of Parkinsons disease: tremor, rigidity, bradykinesia and postural instability . Observing two or more of these symptoms is the main way that physicians diagnose Parkinsons.

    It is important to know that not all of these symptoms must be present for a diagnosis of Parkinsons disease to be considered. In fact, younger people may only notice one or two of these motor symptoms, especially in the early stages of the disease. Not everyone with Parkinsons disease has a tremor, nor is a tremor proof of Parkinsons. If you suspect Parkinsons, see a neurologist or movement disorders specialist.

    Tremors

    Rigidity

    Bradykinesia

    Postural Instability

    Walking or Gait Difficulties

    Dystonia

    Vocal Symptoms

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