What Can Be Done
After visiting the doctor and discussing options, you can investigate your loved ones sleep hygiene. Sleep Hygiene simply refers to the routines you carry out before going to bed at night, and the environment in which you sleep.
You can find out more about good sleep hygiene here.
Find out more about Parkinsons disease:
Highlights From The Episode
In case you missed it, the August broadcast of Dr. Gilbert Hosts was a very informative conversation, and we encourage you to watch the full episode. For your convenience, weve listed the topics and questions from the episode below with timestamps, so you can skip to what may interest you most:
00:48 Introduction of Dr. Ospina
01:27 Dr. Ospinas presentation about sleep issues
23:37 My husband sleeps fairly well at night but sleeps a lot during the day. How do we get him to not sleep so much during the day?
25:19 My father has had much improvement in his sleep by taking CBD. What is your opinion on this?
27:20 Discussion of OFF time
31:23 Will Prozac affect my sleep? Is it better to take it in the morning or at lunch rather than at night?
32:48 Does deep brain stimulation help insomnia and sleep issues?
35:13 I wake up frequently with leg and foot cramps/dystonia. How should I treat this?
36:51 Is it OK to take Nyquil for insomnia? Melatonin? If so, how much melatonin should I take?
38:05 Could numbness in the feet be associated with restless leg syndrome?
39:36 Can you get accustomed to sleep medications whereby the medication is no longer effective?
40:40 What should I do if Im wide awake in the middle of the night? Should I try to be active and get something done, or should I try to stay in bed?
Everyday Life And Quality Of Life
Insomnia can have serious effects on a persons quality of life. One MyParkinsonsTeam member shared their experience with insomnia. I usually sleep for four hours, wake up, toss in bed for an hour, and sleep for two, usually maxing out at six total, they wrote. Im a mess the next day after 1 p.m. or so. I dont know what PD fatigue is like compared to sleepless fatigue because I cant tell which I am affected by. Likewise, I dont know what my new normal is because I seem to always be tired.
Another member reported having a similar experience. If I do get sleep, its only for a few hours, and then Im up for the rest of the day, they posted. They continued, and wrote their insomnia even affected their ability to hold their job. I had to stop work a few years ago, and that is tough, they shared.
Insomnia can also affect more than just the person with PD. Caregivers, family members, and bed partners can all suffer from the effects of insomnia and related sleep dysfunction. Treating this problem is important not just for you but also for your loved ones.
You May Like: Is Parkinsonism The Same As Parkinson’s Disease
Parkinsons Symptoms Including Pain And Frequent Urination
Pain is a common cause of sleep disturbances in Parkinsons, says Horvat. A study published in June 2019 in the Journal of Pain Research found that about one-third of people with Parkinsons had clinically relevant sleep disturbances, and that central parkinsonian pain was the pain subtype that was most often associated with sleep issues.
Central pain can vary widely from person to person. It can feel like a constant burning or tingling that affects the whole body or it can be an intermittent sharp episode of pain, according to the Parkinsons Foundation.
You should definitely talk to your doctor if pain or Parkinsons symptoms are waking you up or keeping you up at night, to see what your treatment options may be, says Horvat.
Frequent urination can be a sign of several different things, and so its important to pay attention to any other symptoms you may also be having, she says.
Autonomic instability is often present in Parkinsons disease, which basically means the autonomic system is not firing regularly, as it should be, says Horvat. The autonomic system controls functions that keep you alive, including your heartbeat, breathing, and digestion.
This condition can lead to incontinence or urinary retention, she says. This is something to talk with your doctor about there are some medications that can be helpful.
Nighttime Trips To The Bathroom
Waking up frequently during the night to use the toilet is called nocturia and is common among people with Parkinsons. These interruptions in the sleep cycle can have a significant impact on your overall quality of sleep.
If you find yourself getting up more than once during the night to use the toilet, discuss with your doctor to see if there are certain medications that might be helpful. Sometimes this can be corrected by working with an incontinence specialist . Limiting the amount of liquid you drink a couple of hours before bed may help with nocturia as well.
Also Check: Voice Amplifier For Parkinson’s
Poor Sleep Seems To Worsen Parkinsons Symptoms
Parkinsons disease and DLB are often considered to lie on the same continuum of disorders marked by toxic buildup of the alpha-synuclein protein in the brain. While they share common symptoms, including movement and cognitive impairments, cognitive problems tend to develop more quickly in DLB.
Both conditions are marked by sleep disruptions, including REM sleep behavior disorder .
What Types Of Sleep Problems Do People With Parkinsons Disease Have
Parkinsons disease affects every person differently. It also impacts sleep in different ways. People with Parkinsons may have:
- Insomnia, finding it hard to fall asleep.
- Fragmented sleep, waking up many times over the night.
- Excessive daytime sleepiness, finding it hard to stay awake during the day.
- Very vivid dreams, which may cause hallucinations or confusion after waking up.
- Emotional dreams or nightmares, which may make you feel emotionally drained after waking up.
Also Check: Bee Venom Parkinson’s Disease
Effect Of Melatonin On Pd
Two studies reported the effect of melatonin on RBD in patients with PD. In a 12-week, randomized, double-blind, placebo-controlled study, the weekly CIRUS-RBD Questionnaire , was used to assess the efficacy of melatonin on RBD in patients with PD the results showed that the number of RBD events after treatment with 8 weeks of 4 mg PRM was not reduced between groups . The results showed that the number of nights in which a dream enactment event occurred during RBD events was not significantly different between groups . In another randomized, double-blind, placebo-controlled, multicenter trial, Ahn et al. used the RBD screening questionnaire to investigate the efficacy of PRM in patients with PD. Coincidentally, the study of Ahn et al. also showed that the RBDSQ scores after treatment with 4 weeks of 2 mg PRM did not differ from baseline in either group . Results of the qualitative analysis are shown in Table 2.
Table 2. Effect of melatonin vs. placebo on sleep disorders in Parkinson’s disease.
Insomnia And Motor Symptoms Of Pd
Nocturnal motor symptoms of PD frequently contribute to insomnia and can occur in over 60% of patients . This includes symptoms of tremor, dystonia, akinesia, and restlessness. One study evaluated a cohort of 412 patients with PD, 209 of whom had trouble with initiation of sleep or fragmentation during the 5-year study . Motor fluctuations of tremor and rigidity were significantly associated with difficulty falling asleep, obtaining too little sleep and awakening too early in this study. Immobility in bed due to hypokinesia from PD has also been associated with an increased wake after sleep onset . One study evaluated nocturnal mobility in patients with PD by using an accelerometer and number of turnover movements in bed . Turnover movements were negatively correlated with increasing disease duration, levodopa equivalent daily dose, modified Hoehn and Yahr ratings, and UPDRS III scores . This would suggest that sleep dysfunction due to motor symptoms is not as prominent early in or with a less severe disease state.
Also Check: Does Michael J Fox Have Parkinson’s
Good Night: Sleep And Parkinsons Disease
Lack of good sleep can worsen Parkinsons symptoms. In this 45-minute lecture, Dr. Rafael Zuzuárregui addresses causes of sleep loss and the latest treatments for: insomnia, restless leg syndrome, REM sleep behavior disorder, nocturnal urination, hallucinations, wearing off of medication, dystonia and sleep apnea.
Insomnia And Parkinsons Disease
Parkinsons disease comes with its fair share of challenges. Among the most frustrating symptoms of Parkinsons is insomnia, or difficulty sleeping. Research has found that the majority of people with PD experience trouble sleeping, and more than 3,000 members of MyParkinsonsTeam report difficulty sleeping as a symptom. Lack of regular sleep can have tremendous impacts on a persons quality of life. In fact, dealing with a sleep deficit can cause anyone to experience problems with memory and thinking.
Good, restful sleep is vital for people with Parkinsons, but it isnt always easy to get quality sleep. Luckily, there are some ways you can work toward combating insomnia with Parkinsons.
Don’t Miss: Nuevos Tratamientos Para El Mal De Parkinson
Memory Foam And Natural Latex Mattresses: The Best Mattress Types For Neurological Disorders
While it is almost impossible to categorize one mattress option as being the best option, in a wide variety of cases, I often recommend either a memory foam mattress or a natural latex mattress, because of the cradling and calming nature of these components.
Memory foam, for example, is a kind of polyurethane foam that most people are familiar with, and because it is excellent at relieving pressure and distributing weight away from the body, it often relieves restlessness and can induce deeper sleep.
The secret that lies inside memory foam is that it is an open cell foam. This means that as pressure is applied to a section of cells, air is squeezed slowly from one to another. The signature melting in sensation that memory foam provides is caused by air being moved around through microscopic openings.
Its also excellent for people who are either bed bound or spend the vast majority of their time in bed.
This is due to the ability of memory foam to reduce the incidence of bed sores, since it spreads pressure and weight laterally, rather than down, where pinpoint pressure can cause tissue damage.
Memory foam has multiple advantages in addition to pressure point reduction for patients suffering from neurological conditions.
Read Also: Parkinsons And Loss Of Appetite
Sleep: A Mind Guide To Parkinsons Disease
This 36-page booklet explains normal sleep patterns, the body clock, how much sleep we should get, challenges to sleeping well, tips for good sleep hygiene, and sleep in normal aging before discussing symptoms, diagnosis and treatment of sleep disorders, including insomnia, REM sleep behavior disorder, sleep apnea, restless leg syndrome, and daytime sleepiness.
Also Check: Parkinson’s Masked Face Images
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 Else Can I Do To Sleep Better With Parkinsons Disease
Practicing healthy sleep hygiene habits may also promote more restful sleep.
- Get outside during the day. Bright light tells your body its time to be awake.
- Keep your body moving during the day. Even if all you feel up to is a short walk or two, all physical activity offers benefits.
- Try at-home remedies, such as massage or a warm bath. Relaxing your mind may help your body fall asleep.
Dont:
- Take long naps during the day.
- Use stimulants, such as caffeine, within six hours of bedtime.
- Use your bedroom for activities other than sleeping. Go to another room to read, watch TV or work.
Read Also: Parkinson’s Syndrome Vs Disease
Understanding The Side Effects Of Sleeping Tablets
Sleeping tablets dont just affect sleep they may also make you feel drowsy or heavy in the morning, or anxious during the day.
They may interfere with your ability to perform some everyday tasks . The effects you may have will depend on the type of medication and dose taken. Older people are often given lower doses of sleeping tablets as they tend to be more sensitive to their effects.
Many people assume sleeping tablets will help them function normally the next day, but there is little scientific evidence for this. Rather than improving your alertness during the day, some sleeping tablets may actually make your memory and concentration worse.
For example, Benzodiazepines can affect your memory, particularly at night. People may wake up several times during the night, but do not remember doing so in the morning.
Daytime Tips For Better Sleep
- Wake up at the same time every day, using an alarm if you have to.
- Get out of bed right after you wake up. Too much time spent in bed can lead to more waking at night.
- Eat regular, healthy meals, and eat at the same time every day. Three to four small meals are better than 1-2 large meals.
- Limit daytime napping to a 40-minute NASA nap . Too many or too-long naps can make sleep at night more difficult.
- Do not drink coffee, tea, sodas, or cocoa after noon. They contain caffeine and can interfere with normal sleep.
- Do not drink alcohol after dinner. It may help you fall asleep faster, but makes sleep shallower later in the night. Alcohol can also make snoring and sleep apnea worse.
- Use caution when taking headache and cold medicines. Some contain stimulants that can affect sleep.
- Stop smoking. Cigarette smoking stimulates the body and makes sleep difficult.
- Increase or start doing daily exercise. Regular exercise helps to deepen sleep. Avoid heavy exercise 2 hours before bedtime.
Also Check: Tardive Dyskinesia Parkinson’s Disease
Inflammatory Markers Sleep Disorder Linked In Parkinsons
The lower number of cycles among Parkinsons patients relative to the other two groups could be associated with medication use. Again, the differences between groups were lost when medications were accounted for in the analyses.
A greater degree of motor dysfunction in Parkinsons patients might also play a role, although this was not measured in the study, the team noted.
No sleep measurements differed significantly when comparisons were made between patients with or without RBD regardless of disease type, which suggests that disease differences could play a larger role in arousals and sleep cycle duration changes than the presence of RBD, the researchers wrote.
That hypothesis would merit confirmation from larger sample studies and comparison with a non-neurological control group, the team concluded.
What Future Medications May Be Available For Parkinsons
There are numerous studies investigating new treatments for Parkinsons disease.
There has been new information about the role of autoimmunity and T-cells in the development of Parkinsons disease, possibly opening the door to a role for biologics.
Stem cells are also being investigated as a treatment option for Parkinsons disease.
You May Like: Stage 2 Parkinson’s Disease
Dependency On Sleeping Tablets
In general, prescription sleeping tablets are safe and effective.
Dependence on these medicines does not develop over just a few nights, it develops gradually with long-term use.
Most people are given sleeping tablets by their GP during periods of illness, stress, when in hospital or when they can no longer cope with their insomnia symptoms.
If you use sleeping tablets regularly your body slowly gets used to the drug, and you develop what is called tolerance. This means that the effects of the medication on you is less, so you have to increase the dose in order to get the same effect.
Eventually, sleeping tablets may no longer work, but if you try to stop taking the tablets you cant sleep because of rebound insomnia. You may come to depend on the medication long after it has stopped working.
Brain Changes Can Disrupt Sleep In Pd Patients
The exact cause of sleep disturbances in PD is not completely understood.
The pathophysiological changes begin in the back of the brain and spread to the front.
Hence, the brainstem gets involved earlier in the disease than other areas.
The brainstem has the reticular activating system which controls the sleep-wake cycle.
The RAS also communicates with other areas of the brain using many different neurotransmitters.
Brainstem involvement can change the neurotransmitter balance and modulate the activity of other areas.
This imbalance may manifest as sleep disturbances.
The use of dopamine agonists can produce sleep disturbances by altering neurotransmitter function.
You May Like: What Is Parkinson’s Disease And What Causes It
Rem Sleep Behavior Disorder
REM stands for rapid eye movement. This is the stage of sleep when dreams take place. People with REM sleep behavior disorder act out their dreams, which can be violent. RBD is one of the early warning signs of Parkinsons. Healthy people with RBD have a higher risk of developing Parkinsons. RBD can be treated with the drug clonazepam .