Parkinson’s Disease & Sleep Issues
Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized in the literature as a multi-system and multi-symptomatic disorder (Willis et al., 2022). The progression of symptoms varies from case to case, with the most common symptoms appearing as tremors, stiffness, rigidity, and difficulty with balance and coordination. However, there are many non-motor symptoms that can develop long before ever receiving a PD diagnosis. Sleep disturbances are one of the many non-motor symptoms experienced by people with PD, affecting up to 96% of the population (Sobreira-Neto et al., 2017).
After several conversations with individuals in the Parkinson's space, I concluded that many people with PD experience the common sleep issues listed below. As you read, you may recognize or relate to many of the following problems and learn a few non-pharmacological strategies to support a better night’s sleep. Of course, not all individuals experience all of the symptoms listed below, and not all strategies work for every individual.
This blog post is a helpful resource for those who need a bit of help navigating their PD and sleep. Find what works for you, and always remember to talk to your doctor about any sleep issues you are experiencing. If you are unsure whether or not you are getting a good night's rest, here is a short video on how to find out https://youtu.be/Ph3PqgF47rw.
Some of the most common sleep issues noted:
Insomnia: Difficulty falling asleep, staying asleep, or waking earlier than desired. According to the American Academy of Sleep Medicine, This experience must occur up to three times a week for at least three months (2014). In addition, it should be noted that many motor and non-motor symptoms of Parkinson’s can influence the symptoms of insomnia (Zuzuárregui & During, 2020).
Excessive daytime sleepiness (EDS): Feeling tired during the day, even after getting enough sleep at night.
Restless legs syndrome: An uncomfortable sensation in the legs that makes it difficult to sit or lie still, often occurring at rest.
REM sleep behavior disorder (RBD): A condition in which people act out their dreams while asleep. It should be noted that while RBD only affects 0.5-1% of the population, it affects up to 50% of people with PD (Zuzuárregui & During, 2020).
Sleep apnea: A condition in which breathing is interrupted during sleep.
Tips for getting a good night's sleep with Parkinson's:
Stick to a sleep schedule. Go to bed and wake up at the same time each day, even on weekends. This will help to regulate your body's natural sleep-wake cycle.
Create a relaxing bedtime routine. In the hour or two before bed, do something calming and relaxing, such as reading, taking a bath, or listening to soothing music. Avoid using electronic devices in the hour before bed, as the blue light emitted from these devices can interfere with sleep. Instead, add a breathing exercise to your bedtime routine. Click here for Breathing Techniques for Better Sleep!
Make sure your bedroom is dark, quiet, and cool. These conditions are ideal for sleep. If your bedroom is too bright or noisy, try using blackout curtains, a sound machine, or earplugs.
Limit caffeine and alcohol before bed. Caffeine and alcohol can both interfere with sleep. Avoid caffeine after lunchtime, and limit your alcohol intake to no more than one drink per day.
Get regular exercise. Exercise can help to improve sleep quality. However, avoid taxing physical exercising too close to bedtime, as this can make it harder to fall asleep. Instead, try gentle stretching, yoga, or meditation closer to bedtime to support calming the body and mind before bed.
Nap during the day if you need to. But keep naps short, no more than 30 minutes (setting an alarm can help), and avoid napping late in the day.
See a doctor if you're having trouble sleeping. If you've tried the above tips and you're still having trouble sleeping, talk to your doctor. They may be able to prescribe medication or other treatments to help you get a good night's sleep.
If you are experiencing any of these sleep problems, it is important to talk to your doctor. They can help you identify your sleep problems' cause and recommend treatment options.
Conclusion
Getting a good night's sleep is essential and can help prevent further complications. Because people with Parkinson’s experience sleep problems more regularly and often severely, it’s especially important for people with Parkinson's to take note of their sleeping habits and work to get the recommended amount of sleep. By following the tips above, you can improve your sleep quality and reduce the impact of Parkinson's on your daily life.
About the Author
This article was written by Power for Parkinson’s Occupational Therapy Internship Alumna, Adriana Ornelas, OTD. During her internship, Adriana studied the impact of sleep disturbances on the lived experiences of people with Parkinson’s disease.
References
American Academy of Sleep Medicine. (2014). The international classification of sleep disorders – (3rd Ed). (ICSD-3). Darien, IL. https://aasm.org/
Sobreira-Neto, M. A., Pena-Pereira, M. A., Sobreira, E. S. T., Chagas, M. H. N., Fernandes, R. M. F., Tumas, V., & Eckeli, A. L. (2017). High frequency of sleep disorders in Parkinson’s disease and its relationship with quality of life. European Neurology, 78(5-6), 330-337.
Willis, A.W., Roberts, E., Beck, J.C. et al. (2022). Incidence of Parkinson disease in North America. npj Parkinsons Disease, 8(170), 1-7. https://doi.org/10.1038/s41531-022-00410-y
Zuzuárregui, J. R. P., & During, E. H. (2020). Sleep issues in Parkinson’s disease and their management. Neurotherapeutics, 17(4), 1480-1494.