Parkinson’s Disease And Sleep: Challenges, Tips & Teamwork

Parkinson's Disease And Sleep

Sleep is fundamental to our physical health, mental wellbeing, and quality of life. During sleep, our bodies repair tissues and restore energy for the next day. Not only is it important to feel rested, but sleep is also crucial in bodily systems such as maintaining cognition, modulating our immune system and emotional regulation.

For people with Parkinson's disease, sleep becomes even more critical, yet unfortunately more challenging to achieve. The relationship between Parkinson's and sleep is complex: the disease affects sleep quality, while poor sleep can amplify Parkinson's symptoms, creating a cycle that impacts overall health and daily functioning.

Common Sleep Challenges in Parkinson's Disease

Motor Symptoms Affecting Sleep

• Difficulty turning in bed: Reduced mobility can make it hard to find comfortable positions or change positions during the night.

• Nighttime tremors: While tremors typically decrease during sleep, they can sometimes persist and disrupt rest.

• Muscle rigidity: Stiffness and cramping can cause discomfort that interferes with falling or staying asleep.

• Restless leg syndrome: An uncomfortable sensation in the legs that creates an urge to move, particularly problematic at bedtime.

Sleep Disorders Common in Parkinson's

• REM Sleep Behaviour Disorder (RBD): Acting out dreams physically, which can be dangerous and disruptive.

• Sleep fragmentation: Frequent awakenings throughout the night, leading to unrefreshing sleep .

• Insomnia: Difficulty falling asleep or staying asleep.

• Sleep apnoea: More common in people with Parkinson's than in the general population

• Excessive daytime sleepiness: Sudden sleep episodes during the day, sometimes related to medications

  
  

Tips for sleeping with Parkinson’s

There are also non-motor factors that can impact sleep quality when managing Parkinson’s Disease. Things such as nocturia (frequent urination at night), depression and anxiety, pain and discomfort or even medication effects that can cause vivid dreams, insomnia or even day drowsiness. 

An important thing to note is that there are positive steps that can be taken to improve rest quality, these are often classified as “sleep hygiene strategies”. 

Some basics Positive Steps include:  

• Establish a consistent sleep schedule: Aiming to go to bed and wake up at the same time each day, including weekends.

• Create a relaxing bedtime routine: Begin winding down 30-60 minutes before bed with calming activities such as reading, listening to a podcast.

• Optimize your sleep environment: Keep the bedroom cool, dark, and quiet.

Movement and Mobility Solutions

• Bed mobility aids: Satin sheets or aids such as bed sticks can help with turning and getting in/out of bed

• Regular exercise: Daily physical activity, completed at least 4 hours before bedtime, can improve sleep quality

Managing Medications

• Timing adjustments: Work with your doctor to optimise medication timing—some may work better if taken earlier or later.

• Evening medication considerations: Avoid stimulating medications close to bedtime.

• Sleep aids: Discuss appropriate sleep medications with your neurologist, as some common sleep aids may worsen Parkinson's symptoms.

Lifestyle and Environmental Factors

• Limit screen time: Avoid electronic devices at least 1 hour before bed

• Manage stress: While this may sometimes be difficult, practice relaxation techniques like deep breathing, meditation, or gentle stretching

• Dietary considerations: Avoid large meals, caffeine, and alcohol close to bedtime

Working with Your Healthcare Team

Sleep problems are common and not something to be ignored. It is always worth discussing any of these challenges with your healthcare team and can even help to keep a sleep diary which records any observations you’ve made around these challenges.

Whether it's difficulty falling asleep, staying asleep, early morning awakenings, or daytime fatigue. Your neurologist, along with other specialists, can help develop a comprehensive approach to improving your sleep.

Remember that better sleep can lead to improved mood, better symptom management, and enhanced quality of life. While sleep challenges in Parkinson's can be frustrating, many effective strategies and treatments are available. With patience, persistence, and professional guidance, most people with Parkinson's can achieve more restful nights and more energetic days.