Parkinson’s Disease and Sleep Problems: Symptoms, Treatments

Parkinson’s disease and sleep issues affect around 75% of patients. Despite the importance of sleep when dealing with a long-term illness, most people with PD experience sleep issues at some stage of their condition. Sleep problems often occur long before motor symptoms have begun, making them one of the first signs of Parkinson’s disease. Some of the most common sleep problems in PD are insomnia, restless leg syndrome (RLS) and excessive daytime sleepiness. Parkinson’s can also cause night-time disturbances such as sleep apnea, bad dreams and frequent night-time urination. Let's explore Parkinson's disease and sleep problems in more detail.

Parkinson’s Disease and Sleep: Common Symptoms

Sleep problems can occur at any stage of Parkinson’s disease. Some of the most common sleep problems for PD patients include:

• Insomnia: Difficulty falling or staying asleep
• Excessive daytime sleepiness: Feeling drowsy or fatigued during the day. In Parkinson’s, sleeping all day is also common
• Nightmares or night terrors: Bad dreams that seem unusual for you
• Sleep attacks: Sudden, involuntary episodes of sleep, also known as narcolepsy
• Periodic leg movement disorder (PLMD)
• Restless leg syndrome (RLS)
• REM sleep behavior disorder: Acting out dreams while asleep
• Sleep apnea: When breathing becomes obstructed during sleep
• Nocturia: Frequent night-time urination

“When prescribing one of the drugs I take, my doctor warned me of a common side effect: exaggerated, intensely vivid dreams. To be honest, I've never really noticed the difference. I've always dreamt big.”  ― Michael J. Fox

What Causes Sleep Problems in Parkinson’s Disease?

There are many reasons why Parkinson's disease and sleep problems are so prevalent, including disrupted routines, medication and chemical changes in the brain ("How Parkinson’s Disease Affects the Brain"). One study by UCLA researchers found that patients with Parkinson's disease and sleep disorders displayed a deficiency of orexin and hypocretin (Hcrt) cells which impacted the brain’s ability to regulate sleep/wake cycles normally.

Insomnia symptoms can also occur as a result of the motor symptoms of Parkinson's disease, or as a side-effect of medication. Tremor, stiffness and involuntary movements can all affect your ability to fall or stay asleep comfortably, which is why treating your condition with medication may be vital for good sleep.

Parkinson’s Disease Sleep Disorders: Treatment and Tips

If you’re experiencing sleep problems in Parkinson’s disease, your doctor may suggest changing or altering your medication. Some medications act as stimulants and can keep you awake. Others may wear off at night and cause a worsening of PD symptoms. If this happens, your doctor may suggest switching you to a drug that’s delivered to your body continuously, such as skin patches or levodopa infusions.

If changing your medication doesn’t help, you may be referred to a specialized sleep clinic. You may also need certain breathing equipment during the night if your sleep apnea is severe.

There is plenty you can do to improve your sleep health. Here are some tips to overcoming sleep disturbances in Parkinson’s disease:

• Don’t drink water for a couple of hours before bed
• Avoid caffeine, alcohol and other stimulants ("Can You Drink Alcohol with Parkinson’s Disease Medication?")
• Create a relaxing night-time routine that doesn’t involve talking about heavy topics before sleep, watching TV or eating a heavy meal before you lie down
• Enjoy a warm bath in the evening before you go to bed
• Do something relaxing before sleep, such as reading or listening to an audiobook
• Get plenty of fresh air and exercise throughout the day, though you should avoid activity at least 2 hours before bed
• If possible, make sure your bedroom temperature is between 60-65 degrees Fahrenheit
• Reduce noise and light in the bedroom

Parkinson's disease and sleep problems can disrupt your quality of life and cause you to feel anxious about bedtime. There is almost always a solution, however, whether it's small changes you can make at home or adjustments to your treatment with guidance from your doctor.

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