Sleep and Parkinson’s disease are intertwined. Most Parkinson’s sufferers have difficulty sleeping at some point. Some sleep disorders, such as REM sleep disorder, can be caused by the disease itself. You may also suffer from sleeplessness or exhaustion throughout the day. It is possible to find treatments that will help you get a good night’s sleep.
What is Parkinson’s disease?
When nerve cells in one section of the brain progressively degrade (become injured) or die, it’s called Parkinson’s disease. As the damage to your nerves worsens, you begin to experience symptoms all over your body.
A primary symptom of Parkinson’s disease is a loss of motor control. Medical professionals refer to any symptoms that make it difficult for you to move as having “motor symptoms” (or control your movements).
Motor symptoms of Parkinson’s disease include:
- Stubborn muscle.
- Tremors (uncontrollable shaking, usually in the hands or legs)
- Injuries to the lower body, such as a fall.
- Slow and deliberate movements (bradykinesia).
Additionally, Parkinson’s disease can generate a wide range of non-motor symptoms, such as tremors. Your body and mind will react differently to each of these difficulties. There are a number of non-motor symptoms that can have an effect on your mood, sense of smell, or vision.
What’s the relationship between Parkinson’s and sleep?
Intricate links exist between Parkinson’s disease and sleep that no one, not even scientists, is sure of.
Parkinson’s disease might induce sleep disturbances in some patients. Symptoms of Parkinson’s disease, such as insomnia, maybe one of the earliest indicators of the disease, according to one study. Thrashing in your sleep may be one of these indicators, as well.
Treatments for Parkinson’s disease and difficulties dealing with one’s emotions are just two examples of possible confounders. One thing is for certain: a good night’s sleep can be difficult to come by for many persons with Parkinson’s disease.
How does Parkinson’s disease cause sleep problems?
The link between Parkinson’s disease and poor sleep quality is still being studied in great depth. As of now, medical professionals feel that the following factors may be to blame:
- Chemical changes in the brain: Parkinson’s illness may affect sleep-wake cycles, according to ongoing studies. Parkinson’s patients may experience sleep deprivation due to altered levels of specific brain neurotransmitters.
- Medication: Getting to sleep or staying asleep can be hampered by some Parkinson’s disease medications. Taking a drug that makes you drowsy throughout the day can also cause sleep disturbances (and wide awake at night).
- Mental health challenges: Mood disorders, such as anxiety or depression, are common among Parkinson’s patients. You may have trouble sleeping if you suffer from a mood problem.
- Parkinson’s symptoms: It can be difficult to get a good night’s sleep if you suffer from pain or other symptoms of Parkinson’s disease. Sleep disturbances can also be caused by sleep apnea, which is more common in Parkinson’s patients in their latter stages.
What types of sleep problems do people with Parkinson’s disease have?
Every person with Parkinson’s disease is affected differently. It affects sleep in a variety of ways, as well. Parkinson’s disease patients may experience:
- Insomnia, unable to sleep at night.
- Fragmented sleep, frequently awoke in the middle of the night.
- Excessive daytime sleepiness, unable to stay awake during the day.
- Very vivid dreams, When you wake up, you may have hallucinations or a lack of clarity.
- Emotional dreams or nightmares, as a result of which, when you wake up, you may feel emotionally depleted
What is REM sleep behavior disorder?
As many as half of Parkinson’s disease sufferers may have this condition. In dreams, your body “acts out,” producing erroneous or perhaps harmful movements while you sleep. Early indications of Parkinson’s may include REM sleep behavior problems, according to some studies.
What other types of sleep disorders do people with Parkinson’s disease have?
People with Parkinson’s disease are more likely to suffer from sleep disturbances such as:
- Circadian rhythm sleep disorders.
- Nocturia (waking often at night to pee).
- Restless legs syndrome.
- Sleep apnea.
When do people with Parkinson’s have sleep problems?
Some people with Parkinson’s disease have trouble sleeping, but not everyone does. If so, they can happen at any time, whether before or after you’ve been diagnosed with Parkinson’s disease.
What else can I do to sleep better with Parkinson’s disease?
Improved sleep quality can also be achieved by following good “sleep hygiene” practices.
- Get some fresh air during the daytime. When the sun rises, your body knows it’s time to get up and go about your day.
- Throughout the day, make sure to keep moving. Even if you can only manage a few short walks a day, getting some exercise is still beneficial.
- Massage or a warm bath are two good options for treatment you may do at home. It’s possible that calming your mind will assist you in drifting off to sleep.
- Daytime naps should be at least two hours.
- Within six hours of the night, do not take stimulants like caffeine.
- Sleeping isn’t the only use for your bedroom. Reading, watching TV, or working can be done in another room.
Are over-the-counter sleep aids (medications) safe for people with Parkinson’s disease?
They’re not, and that’s a bummer. If you’re having trouble sleeping, it’s tempting to turn to over-the-counter sleeping aids as a quick fix. People with Parkinson’s disease, on the other hand, maybe at greater risk.
Some sleep aids, both over-the-counter and prescribed, have been shown to worsen sleep issues. Parkinson’s drugs and several sleep aids might have dangerous drug interactions. Before taking any new drug, especially a sleep aid, talk to your doctor first.
When should I call my healthcare provider?
If you’re having difficulties sleeping and it’s affecting your quality of life, contact your healthcare practitioner. If you’re concerned about any symptoms you’re experiencing, don’t hesitate to contact your healthcare professional.
If you’re having trouble sleeping, it’s possible that you’re suffering from depression brought on by Parkinson’s disease. You can get help if you’ve lost interest in hobbies you once enjoyed or if you’ve become numb to the events taking place in your life. After taking an antidepressant or chatting to a friend about how they’re feeling, some people report feeling better. You are not obligated to feel this way.
Sleep Disorders Related to Parkinson’s Disease
Parkinson’s disease patients are more likely to experience the following sleep disorders:
- Circadian rhythm disruptions: Dopamine depletion has the potential to have a substantial impact on the body’s sleep-wake cycle. They may suffer from insomnia and daytime tiredness as a result of this circadian rhythm disruption.
- REM sleep behavior disorder: Up to 50% of patients with Parkinson’s disease have a sleep problem called REM sleep behavior disorder (RSBD). People with this condition act out their dreams without even realizing they are doing so. Violence, such as hitting a sleeping partner, maybe part of their bodily movements. People with REM sleep behavior disorder, as opposed to sleepwalkers, are more likely to recall and characterize their dreams as vivid. There is a link between REM sleep behavior disturbance and a greater risk of cognitive deterioration in Parkinson’s patients.
- Obstructive sleep apnea: It is common for people with OSA to experience frequent interruptions in breathing that disrupt their sleep, which is often accompanied by loud snoring or gasping sounds as they sleep. OSA is more likely to occur in people with Parkinson’s disease because of symptoms such as upper airway blockage, restrictive lung disease, and other risk factors.
- Restless legs syndrome: An overwhelming desire to move one’s legs, especially while in rest, is a symptom of restless legs syndrome. Between 30 and 80 percent of Parkinson’s patients suffer from a sleep disorder known as narcolepsy. Parkinson’s disease and restless legs syndrome may be linked, according to some theories, to a deficiency in the body’s supply of dopamine.
- Nocturia: The great majority of Parkinson’s patients suffer from midnight urination, or nocturia, to some extent. Frequent nightly urination, even if it is not an asleep problem, can disrupt sleep quality and lead to less restorative sleep.
The Relationship Between Parkinson’s Disease and Sleep
Parkinsonian symptoms may worsen because of poor sleep, but it’s not obvious which causes the other. A bidirectional effect is likely to be at work here, with one factor amplifying the effects of another.
Sleep deprivation and fragmented sleep may increase the brain’s vulnerability to oxidative stress, which has been linked to Parkinson’s disease progression. A major fraction of the brain’s cells is already destroyed by the time an individual with Parkinson’s disease has enough motor symptoms to be identified. If the onset of parkinsonian symptoms is preceded by symptoms of poor sleep or sleep problems, this could help in the early detection of the disease.
Parkinson’s disease and sleep have a complicated link that requires more investigation. Medical professionals may be able to identify at-risk patients earlier if they have a better grasp of the link between the two.
Parkinson’s Sleep Problems: Diagnosis and Treatment
A chronic and progressive condition, Parkinson’s deteriorates over time. It’s possible to alleviate symptoms and improve sleep quality with the right therapy alternatives.
Adopting healthy sleep patterns is the quickest and easiest approach to improve your quality of sleep while living with Parkinson’s disease.
Parkinson’s disease patients can benefit from the following suggestions for good sleep hygiene:
- Maintaining a regular nighttime routine for your child.
- Maintaining a regular sleep routine that includes calming activities such as listening to music or reading a soothing book.
- Regular physical activity, ideally in the morning.
- Getting the right amount of light exposure, whether it’s from the sun or from light treatment.
- Avoiding extended naps and naps towards the end of the day is essential.
- Creating an environment that is cool, dark, and comfortable for sleep.
- Bedtime activities should only include sex and sleep.
- Take a break from technology one hour before going to sleep.
- Reduce the number of liquids you consume before you go to bed.
- Avoiding stimulants such as caffeine, alcohol, and smoke is a good idea as well.
- Avoiding heavy meals at night and eating a healthy diet are the best ways to avoid obesity.
To improve sleep quality and treat particular diseases such as REM sleep behavior disorder in Parkinson’s patients, light treatment, physical activity, and deep brain stimulation have been proven effective. Efficacy of cognitive-behavioral treatment for insomnia (CBT-I) in healthy adults has been demonstrated, however further research is needed to examine the effects of CBT on Parkinson’s disease patients.
Patients who feel they have a sleep issue should talk to their doctor about getting tested, such as with polysomnography, which is a type of sleep study. Multiple sensors track many aspects of sleep, including the stages of sleep, eye movements, and other relevant data, all throughout the course of an overnight examination.
If a sleep issue is found, it can be treated to alleviate any negative effects it may have. Patients with REM sleep behavior disorder, for example, need a safe sleeping environment to prevent injury to themselves or a bed partner from occurring when they act out their dreams during their sleep. A patient with obstructive sleep apnea, on the other hand, may choose to utilize a CPAP machine in order to ensure uninterrupted breathing.
Parkinson’s disease sleep problems are addressed with a number of drugs and sleep aids, such as melatonin. Before using any over-the-counter or prescription medication to help with your sleep issues, make an appointment with your doctor. An individual treatment plan can be devised for you by your doctor, depending on the circumstances. Changing drugs, adjusting dosages, adjusting schedules, or removing medications that interfere with sleep are all options that may be considered.
Tips for Better Sleep
- Try to stick to a regular sleep routine, so that you can get up at the same time every day.
- Decide on your wake-up time before setting a bedtime. Ideally, you should be in bed for seven to eight hours each night.
- Develop and adhere to a nightly routine that includes things like a snack, a bath, brushing teeth, and using the bathroom.
- Spend as much time as you can outside and get some exercise every day. Avoid exercising after 8:00 p.m.
- Sitting or working near a light therapy box is an option if you can’t get outside. You can find them in drugstores and department stores.
- Taking a sleep is fine as long as you do it at the same time every day and no later than 3:00 p.m.
- The bed should be reserved for sleeping and sex, and should not be used for anything else.
- When in bed, avoid reading or watching television.
- To make getting into bed a little bit easier, try satin sheets and pajamas.
- Prevent overnight urination by limiting liquid intake for three hours before bedtime.
- Before going to bed, use the restroom immediately.
- Make it easier to get out of bed at night by placing a commode and a lamp next to your bed.
- Alcohol, caffeine, and other stimulants such as nicotine
- Heavy late-night meals (although a light snack at bedtime may be helpful)
- 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.
- Remeron (mirtazapine) may aid with sleep, although SSRIs can worsen other sleep-related problems.
- If frequent urination keeps you awake at night, check with your doctor to see if there are any other possibilities besides PD. As a further option, there are a number of drugs that can be beneficial, including oxybutynin, trospium, tofenacin succinate, mirabegron, and phenoperidine fumarate (Toviaz and Toviaz Plus). Referrals to a bladder specialist may be made (urologist).