Parkinson’s Sleep Disorders

Parkinson’s Sleep Disorders – Introduction

Sleep disorders can significantly impact the quality of life for individuals with Parkinson’s disease. In this blog post, we will uncover 10 commonly experienced sleep disorders associated with Parkinson’s, shedding light on their symptoms, causes, and potential solutions. Whether you are Living with Parkinson’s, a caregiver or simply curious about Parkinson’s sleep disorders, this friendly guide aims to provide valuable insights for better sleep and improved overall well-being. So, let’s dive in and unmask these Parkinson’s sleep disorders together.

Understanding Parkinson’s Sleep Disorders

Parkinson’s disease can often be accompanied by various sleep disorders, which can significantly impact the quality of life for individuals living with this condition. There are approximately 10 different types of sleep disorders that can affect people with Parkinson’s, including insomnia, restless legs syndrome, and sleep apnea. These sleep disturbances can disrupt normal sleep patterns, leading to excessive daytime sleepiness, fatigue, and impaired cognitive function. Individuals with Parkinson’s and their healthcare providers need to understand these sleep disorders to implement appropriate management strategies and improve overall well-being.

Parkinson’s Sleep Disorders: The Culprits Behind Your Sleep Woes

Disclaimer: I am not a Medical Professional. The information being shared is based on my personal experiences with some of these sleep disorders as a person living with Parkinson’s and/or research that I conducted. The information being provided is

Let’s look at the 10 Parkinson’s sleep disorders in more detail to provide a better understanding of how Parkinson’s disease can have detrimental impacts on your sleep.

Sleep Fragmentation

This means their sleep is broken up by frequent awakenings, whether brief or lasting several minutes. While occasional arousals are normal, consistent fragmentation disrupts the natural sleep cycle, preventing deep sleep necessary for restoration.

The result? Feeling tired, groggy, and lacking the energy needed to manage Parkinson’s symptoms and daily activities. This fragmented sleep can even worsen other symptoms of the disease, creating a frustrating cycle.

Addressing sleep fragmentation is crucial for improving quality of life and well-being in those living with Parkinson’s.

Excessive Daytime Sleepiness

Excessive daytime sleepiness (EDS) is a significant non-motor symptom affecting up to 50% of individuals with Parkinson’s disease. It manifests as an overwhelming urge to sleep or unintended napping episodes during the day, despite getting adequate nighttime sleep. This sleepiness can strike at any time, even during activities or conversations, impacting social interactions and daily life.

EDS can be caused by various factors in Parkinson’s, including:

• Fragmented sleep: Frequent nighttime awakenings disrupt the sleep cycle and prevent individuals from reaching restorative deep sleep stages, leading to daytime fatigue.
• Dopamine deficiency: Dopamine plays a critical role in wakefulness, and its depletion in Parkinson’s can contribute to daytime sleepiness.
• Medications: Some medications used to manage Parkinson’s symptoms can have drowsiness as a side effect.

REM Sleep Behavior Disorder (RBD)

REM Sleep Behavior Disorder (RBD), a sleep disturbance impacting up to half of those with Parkinson’s. During this complex condition, the normal muscle paralysis experienced in REM sleep is lost, causing individuals to “act out” their dreams.

This can range from simple mumbling or limb movements to complex scenarios involving striking, running, or even shouting.

The consequences of RBD go beyond disrupted sleep. The possibility of injuring oneself or a bed partner due to dream enactment poses a significant safety concern.

Additionally, the lack of deep sleep due to RBD can lead to daytime fatigue and worsen other Parkinson’s symptoms. While the exact cause remains under investigation, it is believed to be linked to the degeneration of brain cells that control movement and sleep regulation.

Diagnosing RBD often involves a combination of sleep studies and discussions with a medical professional.

Restless Leg Syndrome (RLS)

This neurological condition manifests as an irresistible urge to move the legs, primarily in the evenings and at rest, often accompanied by uncomfortable sensations like crawling, tingling, or burning.

The urge to move can be so intense that it disrupts sleep, leading to difficulty falling asleep and staying asleep.

The connection between Parkinson’s and RLS is not fully understood, but several factors might contribute. Dopamine, a crucial neurotransmitter involved in both movement and sleep regulation, is depleted in Parkinson’s and could play a role in both conditions.

Additionally, iron deficiency, a common occurrence in Parkinson’s, has been linked to RLS development.

Nocturia

Nocturia, the disruptive need to awaken multiple times during the night to urinate, is a common sleep thief for individuals with Parkinson’s.

This frequent nighttime bathroom demand fragments their sleep and prevents them from reaching deeper, restorative sleep stages. Several factors contribute to nocturia in Parkinson’s.

First, reduced bladder capacity due to the disease or medications can lead to a smaller functional holding volume.

Second, neurodegeneration affecting bladder control can disrupt signals telling the brain when it’s time to go.

Thirdly, excess fluid production at night (nocturnal polyuria) can exacerbate the problem.

The result is sleep deprivation, with consequences like daytime fatigue, mood disturbances, and a decline in quality of life.

Circadian Rhythm Disorders

Parkinson’s disease can throw a wrench into the body’s internal clock, leading to circadian rhythm disorders. This disrupts the natural 24-hour cycle that governs sleep-wake patterns, temperature regulation, and hormone release.

In people with Parkinson’s, these disruptions can manifest in several ways:

• Delayed sleep phase syndrome: Difficulty falling asleep and waking up at desired times, often leading to feeling tired throughout the day.
• Advanced sleep phase syndrome: Falling asleep and waking up earlier than desired, potentially resulting in fragmented sleep and daytime fatigue.
• Irregular sleep-wake cycle: Fluctuating sleep and wake times throughout the day and night, making it challenging to establish a consistent sleep schedule.

These disrupted rhythms not only impact sleep quality but can also worsen other Parkinson’s symptoms like tremors, rigidity, and difficulty walking.

Additionally, the lack of sunlight exposure and decreased physical activity associated with circadian rhythm disorders can further contribute to fatigue and mood problems.

Sleep Apnea

Sleep apnea disrupts the natural flow of sleep in many individuals, and those with Parkinson’s disease are more likely to experience this condition compared to the general population.

Sleep apnea can cause a person to stop and start breathing again, multiples times during the night which can cause your oxygen levels to drop and can lead to health issues.

While some people might not wake up during these episodes, they can still disrupt sleep quality and lead to fragmented sleep. This fragmented sleep, combined with the decreased oxygen levels, can contribute to daytime sleepiness, fatigue, and a decline in cognitive function.

Several Risk Factors for Sleep Apnea include: Age (increase with age up to 60 to 70 years old), Sex (higher in men), Body Mass Index (BMI) (increases with higher BMI), Cigarette Smoking and Family History.

Additionally, some medications used to manage Parkinson’s symptoms can have side effects like drowsiness and can worsen sleep apnea.

Sleep Apnea is usually diagnosed during a sleep study prescribed by your doctor,

Parkinson’s Sleep Disorders – References

Clinical Challenges: Sleep Problems in Parkinson’s Patients, Medpagetoday.com, Salynn Boyles, October, 17, 2018.

Sleep and Parkinson’s Disease, Missouri Medicine, Pradeep Bollu, M.D. and Pradeep Sahota, MD, September-October 2017.

Sleep Dysfunction and its Management in Parkinson’s Disease, Current Treatment Options in Neurology, Scott Kutscher, M.D., et all. August 2014

REM Sleep Behavior Disorder (RBD), Cleaveland Clinic, 11/22/22

Restless Leg Syndrome, Mayo Clinic Article

Urology Care Foundation -Nocturia, Urologyhealth.org.

For additional resources on Parkinson’s sleep disorders read my articles:

Parkinson’s and Fatigue – 7 Reliable Strategies to Overcome Exhaustion

Parkinson’s Sleep Disorders Practical Solutions for Better Sleep

Let’s look at some benefits and solutions for overcoming the 7 Parkinson’s sleep disorders.

Benefits of Overcoming Sleep Fragmentation in Parkinson’s:

• Improved sleep quality: Reduced awakenings lead to deeper, more restorative sleep, leaving you feeling refreshed and energized in the morning.
• Enhanced daytime alertness and reduced fatigue: Improved sleep quality translates to better focus, concentration, and cognitive function throughout the day, allowing you to participate more actively in daily life.
• Reduced risk of other health problems: Fragmented sleep has been linked to various health concerns, including depression, anxiety, cardiovascular risks, and diabetes. Addressing sleep fragmentation can potentially reduce the risk of these issues.
• Improved management of other Parkinson’s symptoms: Better sleep can contribute to improved control over tremors, rigidity, and other Parkinson’s symptoms, leading to a higher quality of life.
• Increased emotional well-being: Feeling rested and alert can significantly improve mood, reduce frustration, and enhance overall emotional well-being.

Solutions for Overcoming Sleep Fragmentation in Parkinson’s:

1. Addressing underlying causes:

• Work with your doctor to address any medical conditions contributing to frequent awakenings, such as pain, urinary urgency, or sleep apnea.
• Adjust medications: Discuss with your doctor if any medications are causing sleep disturbances and explore alternative options if possible.

2. Improving sleep hygiene:

• Maintain a consistent sleep schedule: Go to bed and wake up at the same time each day, even on weekends, to regulate your body’s natural sleep-wake cycle.
• Create a relaxing bedtime routine: Engage in calming activities like reading, taking a warm bath, or listening to soothing music before bed.
• Optimize your sleep environment: Ensure your bedroom is cool, dark, and quiet to promote sleep.
• Limit daytime napping: Short naps (20-30 minutes) are permissible, but avoid napping late in the afternoon to prevent disrupting nighttime sleep.

3. Relaxation techniques:

• Practice relaxation techniques like deep breathing exercises, progressive muscle relaxation, or meditation before bedtime to calm your mind and prepare for sleep.

Benefits of Overcoming Excessive Daytime Sleepiness (EDS) in Parkinson’s:

• Enhanced alertness and energy: Reduced daytime sleepiness leads to increased focus, motivation, and participation in daily activities and social interactions.
• Improved cognitive function: Better sleep quality can improve memory, learning, and reasoning abilities, allowing you to think more clearly and perform tasks effectively.
• Reduced risk of falls and accidents: Improved alertness leads to better coordination and reaction time, lowering the risk of falls and injuries throughout the day.
• Enhanced emotional well-being: Feeling less tired and more alert can improve mood, reduce frustration, and increase overall sense of well-being.
• Improved management of other Parkinson’s symptoms: Reduced fatigue can positively impact other Parkinson’s symptoms like tremors, rigidity, and difficulty walking, leading to a better quality of life.

Solutions for Overcoming EDS in Parkinson’s:

1. Addressing underlying causes:

• Work with your doctor: Assess potential causes of EDS like sleep fragmentation, depression, or side effects of medications.
• Optimize sleep hygiene: Implement consistent sleep schedules, relaxing bedtime routines, and a comfortable sleep environment like mentioned in the previous response.
• Manage sleep apnea: If present, use a CPAP machine to ensure proper oxygen levels during sleep.

2. Lifestyle modifications:

• Regular exercise: Engage in regular physical activity, but avoid strenuous exercise close to bedtime.
• Limit caffeine and alcohol: These substances can disrupt sleep patterns and worsen EDS.
• Maintain a healthy diet: Eat a balanced diet and stay hydrated throughout the day, avoiding heavy meals before bedtime.
• Planned napping: If necessary, schedule short naps (20-30 minutes) early in the afternoon to manage fatigue without disrupting nighttime sleep.

3. Medications:

• Discuss with your doctor: Explore options like dopamine agonists, stimulants, or modafinil, which may help improve alertness and manage EDS symptoms.
• Medications for underlying conditions: Address other contributing factors like depression or anxiety with appropriate medication.

REM Sleep Disorder

RLS:

• Solutions: Maintaining a regular sleep schedule, avoiding caffeine and alcohol, trying warm baths or massages before bed, and exploring medication options with your doctor can alleviate symptoms.
• Benefits: Increased sleep quality, reduced restless movements, improved mood and energy levels, and less daytime discomfort can lead to greater daily enjoyment and productivity.

Nocturia

• Solutions: Limiting fluids before bed, elevating the head and torso while sleeping, addressing underlying bladder conditions, and exploring medication adjustments might be helpful.
• Benefits: Improved sleep continuity, reduced fatigue, enhanced daytime alertness, and better urinary control can contribute to a more active and fulfilling life.

Restless Leg Syndrome (RLS)

• Solutions: Maintaining a regular sleep schedule, avoiding caffeine and alcohol, trying warm baths or massages before bed, and exploring medication options with your doctor can alleviate symptoms.
• Benefits: Increased sleep quality, reduced restless movements, improved mood and energy levels, and less daytime discomfort can lead to greater daily enjoyment and productivity.

Circadian Rhythm Sleep Disorders

• Solutions: Implementing consistent sleep and wake times, maximizing exposure to natural light during the day, avoiding bright screens or stimulating activities before bed, and considering light therapy can help regulate the internal clock.
• Benefits: Deeper sleep, improved mood and cognitive function, reduced daytime fatigue, and better synchronization with social and daily routines can significantly enhance quality of life.

Sleep Apnea

• Solutions: Using Continuous Positive Airway Pressure (CPAP) therapy, adopting weight management strategies, avoiding alcohol and sedatives before sleep, and adjusting sleeping positions can address airway obstructions.
• Benefits: Reduced risk of cardiovascular complications, improved oxygenation during sleep, enhanced energy levels, and improved cognitive function can lead to a healthier and more vibrant life.

Parkinson’s Sleep Disorders – Conclusion

While navigating Parkinson’s sleep disorders presents numerous challenges, reclaiming a good night’s sleep is not a lost cause.

By understanding the diverse sleep disruptions commonly experienced, exploring available solutions, and working collaboratively with your healthcare team, you can take significant strides towards better rest and an enhanced quality of life.

Remember, a good night’s sleep empowers you to manage other Parkinson’s symptoms more effectively, engage more fully in daily activities, and experience the joy of living a life enriched by both rest and activity.

Don’t hesitate to seek support and advocate for your sleep needs – a world of better sleep, and a brighter, more energetic future, awaits.