If you or a loved one has Parkinson's disease, you know how challenging it can be to get a good night's sleep. It can be exhausting to go to bed after a hard day, tossing and turning, or waking up every hour. But you don't have to face this alone. Many people with Parkinson's have this problem. So, why does this happen? What can we do about it? Let's talk about all this in a very simple and friendly way today.
Let's first look at what Parkinson's Disease is.
Simply put, Parkinson's disease is a condition in which the nerve cells in the brain that control our movements are gradually damaged or destroyed over time. As these nerve cells become damaged, various symptoms begin to appear in our body.
This is mainly a movement disorder . This means it affects our ability to walk, reach, and balance. You may experience symptoms like these:
- Stiff muscles: A feeling of tightness in the muscles.
- Tremors: Uncontrollable shaking, especially of the hands or legs.
- Problems with balance: Feeling like you are going to lose your balance and fall while walking.
- Slowness of movement (Bradykinesia): A condition in which everything is done very slowly.
But Parkinson's disease doesn't just affect movement. It also has many non-motor symptoms that can affect our mood, sense of smell, and vision.
So, what is the connection between Parkinson's disease and sleep?
Parkinson's disease and sleep have a very complex relationship. It's like a tangled ball of yarn. Even scientists haven't figured out the full mechanism yet.
Sometimes, sleep problems are directly caused by Parkinson's disease. Some studies have shown that sleep problems can be one of the earliest symptoms of Parkinson's disease . For example, sleepwalking and hand-foot-and-mouth movements can be a sign of the disease.
On the other hand, things like the medications you take for Parkinson's disease and the mental challenges that come with it can also affect your sleep. One thing is clear: For many people with Parkinson's disease, getting a good night's sleep is a dream. Research shows that two out of three (2/3) people with Parkinson's disease have sleep problems.
Why are sleep problems so common among Parkinson's patients?
Doctors have identified several main reasons for this. Let's take a closer look at them.
| Reason | A simple explanation |
|---|---|
| Chemical changes in the brain | Parkinson's disease causes changes in the balance of certain chemicals in the brain. This directly affects our body's sleep-wake cycle. As a result, the amount and quality of sleep can decrease. |
| Medication | Some medications for Parkinson's disease can disrupt sleep. Some medications can cause daytime sleepiness and insomnia. |
| Mental health problems | Anxiety and depression are common among Parkinson's patients. Either of these mental conditions can make it difficult to stay asleep at night or to get a good night's sleep. |
| Other symptoms | Other symptoms of Parkinson's disease, such as body aches and frequent urination at night (nocturia), can also disrupt sleep. Sleep apnea, a condition in which breathing stops during sleep, is also common in the later stages of Parkinson's disease. |
What sleep problems can come with Parkinson's disease?
Parkinson's disease doesn't affect everyone the same way. And so do sleep problems. You may experience things like:
- Insomnia: Staying awake for hours after going to bed.
- Fragmented sleep: Waking up multiple times during the night.
- Excessive daytime sleepiness: Uncontrollable sleepiness during the day.
- Vivid dreams or nightmares: Having very vivid, sometimes frightening dreams. These can cause confusion when you wake up, making you confused between dreams and reality.
A special condition called REM Sleep Behavior Disorder
This is a special condition that affects nearly half of Parkinson's patients. Usually, when we dream, our body temporarily loses consciousness. Therefore, we don't actually do the things we dream about.
But for someone with REM sleep disorder, that control is lost. That means you start to act out the things you dream about. If you're running in your sleep, you'll try to run out of bed, scream, and flail your arms and legs. This can be a bit dangerous for you and for the person sleeping next to you. Some researchers believe that this may be a very early sign of Parkinson's disease.
In addition, several other sleep disorders are common among Parkinson's patients:
- As mentioned earlier, getting up frequently at night to urinate (Nocturia).
- Restless Legs Syndrome is a condition in which the legs feel like they are constantly moving due to unbearable discomfort in the legs.
- Sleep apnea is the cessation of breathing during sleep.
- Problems with the body's biological clock (Circadian rhythm sleep disorders).
How are these sleep problems diagnosed and treated?
If you have a sleep problem, the most important thing to do is to talk openly about it with your doctor. Don't be embarrassed or dismiss it as something trivial. Your doctor will ask you a few questions to get a better understanding of the problem.
To help you during this time, you can keep a sleep journal . For about two weeks, write down details like when you go to bed, when you wake up, how many times you wake up at night, and whether you feel sleepy during the day. This will help your doctor get a better picture of your problem.
If your doctor suspects something is wrong, he or she may refer you for a sleep study . This involves staying overnight in the hospital. While you sleep, your brain activity, breathing, and heart rate are monitored through small sensors (electrodes) attached to your body.
Treatment options depend on the cause of your sleep problems. Your doctor may suggest things like:
1. Changing medications: If your sleep problems are thought to be caused by a medication you take for Parkinson's disease, your doctor may decide to reduce the dosage of that medication or switch you to a different medication.
2. New medications or treatments: If you have a condition like sleep apnea, you may be prescribed a special device (oral appliance/CPAP machine) to help regulate oxygen flow during sleep. There are also special medications for some sleep problems.
3. Lifestyle changes: Our daily habits and sleeping environment also have a big impact on sleep. Simple things like keeping a consistent bedtime and wake-up time, keeping the bedroom dark and quiet, and avoiding looking at your phone or TV before bed can make a big difference.
Other things you can do to get a good night's sleep
We call this good "sleep hygiene." Following these habits will give you great relief.
| Things to do (Do's) ✅ | Don'ts ❌ |
|---|---|
| Go outside during the day. Exposure to sunlight sends a signal to the body that it's time to wake up. | Don't take long naps during the day. It's okay to take a short nap of 20-30 minutes. |
| Keep your body active throughout the day. Even a short walk is fine, any exercise has benefits. | Do not drink caffeine-containing beverages, such as coffee or tea, within 6 hours of going to bed. |
| Relax your mind before going to bed. Things like taking a lukewarm bath or getting a gentle massage can help. | Use the bedroom only for sleeping. Choose another room for reading, watching TV, or working. |
Is it okay to use over-the-counter sleep aids?
Absolutely not. This is very important. While sleeping pills, which you can buy over-the-counter at the pharmacy, may seem like an easy solution, they can pose additional risks for someone with Parkinson's disease.
Most importantly, do not take any over-the-counter sleeping pills without first consulting your doctor. These can interact with your Parkinson's medications and can make your sleep problems worse.
When should you definitely see a doctor?
If your sleep problems are affecting your quality of life, be sure to see your doctor. Don't delay, especially in cases like these:
- If you feel that what you do in your sleep could endanger you or your partner.
- Sometimes these sleep problems can be a symptom of depression , which can come with Parkinson's disease. If you've lost interest in the things you used to enjoy and are feeling down about life, please talk to a doctor you trust. There are treatments that can help with this condition. You don't have to suffer like this.
Researchers are still learning more about the relationship between Parkinson's disease and sleep. That knowledge could help develop better treatments in the future. But there are already many treatments and solutions that can help you. So talk openly with your doctor about your sleep problems. Together, you can develop a plan to improve your sleep and your life.
Take-Home Message
- Sleep problems are very common with Parkinson's disease. This is not your fault.
- There are a number of physical and psychological reasons that affect this.
- Never take sleeping pills from the pharmacy without medical advice. This can make the problem worse.
- Talk openly with your doctor about all your sleep problems (struggling to fall asleep, dreaming, daytime sleepiness).
- There are many effective treatments and lifestyle changes that can help you, so don't give up hope.
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