Parkinson's & Excessive Daytime Sleepiness: To Nap or Not to Nap?
We know from research, general observation, and even first-hand experience, that Parkinson’s disease (PD) can have a detrimental impact on nighttime sleep.
- People with PD may struggle to fall asleep or to maintain sleep (insomnia).
- Sleep fragmentation (frequent nighttime awakening) is common in people with PD.
- PD symptoms can disrupt sleep, including anxiety or depression, excessive sweating, tremors, frequent urination, and body incoordination.
- Medications used to treat PD can also lead to sleep problems, including nightmares, insomnia, withdrawal symptoms mid-way through the night causing wakefulness, and restless legs
And with poor sleep comes problems during the day with unwelcomed sleepiness. Can daytime napping help or hinder one’s energy and alertness if they have PD?
Benefits of napping for Parkinson's
Excessive daytime sleepiness (EDS), defined by the Davis Phinney Foundation for Parkinson’s, is “an inability to maintain wakefulness and alertness during the major waking episodes of the day that results in periods of irrepressible need for sleep or unintended lapses into drowsiness or sleep.”1 In other words, EDS can be life-altering and disabling for people with PD.
Daytime napping, when planned and kept to a short period (less than 30 minutes) can be restorative for sleepy folks living with PD. It can also be helpful to take these naps before 3 pm, as they can provide an energizing “second wind” later in the day.
Planned and unplanned napping
Planned napping is an important concept to consider here. Unplanned, or unintended, napping is not the same thing and may be a cause for concern. Unintended sleep episodes can be a dangerous side effect of not getting quality nighttime sleep or could be related to medication side effects. When one suddenly falls asleep, this is a sign that the body and brain are dealing with something out of balance.
These sudden sleep episodes can occur during driving or while performing other tasks where safety may be of concern. Sudden sleepiness, as a regular feature of living with PD, can also disconnect people from activities they love and interfere with time spent with family. Unplanned naps may not be a solution for EDS if they are long-lasting, inconsistent, and do not result in waking up refreshed and energized.
Long naps and Parkinson's risk factor
Research published in Innovation in Aging in 2017 looked at unplanned naps among people aged 65 or older (not accounting for chronic illness) and found that almost 60 percent of those surveyed took unplanned naps. Almost 20 percent of the same baseline population took long naps of more than 1 hour. Both groups’ napping behaviors were associated with poorer self-reported health and a higher number of chronic conditions.2
Some research also points to naps as being associated with a higher risk for developing PD among older men.3 The International Journal of Epidemiology published a study that found that men who napped at least an hour every day were more likely to develop PD. Fortunately, it appears that napping for 30 minutes or less did not result in the same risk factors for PD.
Solutions for daytime sleepiness
The Michael J. Fox foundation offers some simple solutions in sleep hygiene that may help improve nighttime sleep, which by default can help prevent daytime sleepiness:4
- Plan your daytime naps, and limit them to less than 30 minutes. Longer and later naps disrupt circadian rhythms and make it harder to fall asleep at night.
- Stick to a bedtime routine that includes sleep-friendly activities that help you relax, and maintain a consistent bedtime and wake time, even on the weekends.
- Avoid blue spectrum light exposure at night by turning off computers and handheld electronic devices an hour before bedtime. The light emitted from these screens suppresses the melatonin production in the brain which is necessary to help the brain and body transition to sleep.
- Try not to drink too much fluid before bedtime to prevent the need for nighttime trips to the bathroom.
- Avoid caffeine after lunch and alcohol at bedtime. Both will disrupt your ability to fall asleep and stay asleep.
- Daytime exercise (the earlier in the day, the better) can help the circadian system stay on track and usually leads to better sleep at night.
Talk to your doctor about sleep
Here are some questions to ask yourself:
- Are short, planned daytime naps useless against your EDS?
- Do you take short naps that last longer than you intended?
- Do you practice good sleep hygiene and still struggle with nighttime sleep problems and EDS?
If so, this might be a good time to approach a neurologist with your concerns. You might have a medication side effect to address, a hidden sleep disorder, or other health condition that needs treatment.
Have you or your loved one had issues with medication timing?