Sleep Issues

Parkinson's disease (PD) and sleep issues are often related. Most people with PD have sleep problems at some point. PD itself may cause problems, or you may also feel tired during the day. You and your doctor can work together to help you find solutions to help you sleep better.1

Insomnia

Insomnia is a condition in which you cannot get enough sleep nearly every night. Difficulty falling asleep, problems staying asleep, or waking up too early may occur with insomnia.1,2

Many people with PD suffer from depression, which is one of the most common causes of insomnia. There are a few different ways that depression can lead to sleep problems.

When someone is depressed, they often have a lot of negative thoughts and feelings that can keep them from falling asleep or staying asleep. People who are depressed may also feel tired all the time, which can make it hard to get the rest they need. Also, some drugs used to treat depression can cause problems sleeping. Finally, stress and anxiety can also lead to sleep problems.2,3

Restless legs syndrome (RLS)

Restless legs syndrome (RLS) is a condition that causes an uncomfortable feeling in the legs accompanied by an urge to move them. This syndrome can make it difficult to fall asleep and can cause disrupted sleep.4

It is difficult to know how many people with PD also have RLS because symptoms are similar to drug side effects for PD treatment. This complicates diagnosis and treatment.4

Sleep apnea

Sleep apnea results when a person stops breathing while asleep and often awakens to restore breathing. While the person is still in light sleep and may not be aware of these awakenings, the number of awakenings severely disrupts the quality of sleep. The result is little restorative sleep and severe daytime drowsiness.2,5

People with untreated sleep apnea repeatedly stop breathing, sometimes hundreds of times during the night. Obstructive sleep apnea (OSA) occurs more often in later stages of PD, when the airway can be partially or completely blocked while sleeping.2,5

REM sleep behavior disorder

REM sleep behavior disorder (RBD) is a condition that causes people to act out their dreams while they are sleeping. This can include kicking, punching, and yelling.2

People with RBD often do not remember their dreams when they wake up. About half of people with PD also have RBD. RBD can occur years before the motor symptoms of PD are present.2

Why does PD lead to sleep problems?

When it comes to sleep and Parkinson’s disease, it can be complicated. Chemical changes in the brain from PD can disrupt sleep. However, sleep disruptions are usually complex and many factors come into play. For example, drugs that treat PD as well as other conditions could contribute to poor sleep. Lifestyle habits, pain, and muscle stiffness can all add to the problem.1,2

Treatment

While PD has no cure, there are treatments available for sleep problems in people with PD. It is essential to discuss any sleep problems with a doctor. Some treatments include lifestyle changes, medicines, and sleep specialists. If you have sleep apnea, you may need to wear a device a night to help keep your airway open.1,2

It is also crucial to develop good sleep hygiene habits. These habits refer to actions that you can take to help your body prepare for sleep or be alert at a certain time of the day.1,2

Sleep hygiene tips include:2

  • Avoid late-night eating, especially foods that are heavy, rich, or spicy
  • Cut back on caffeine at least 8 hours before bed
  • Avoid alcohol, which can make sleep problems worse
  • Exercise daily
  • Keep naps to 20 to 30 minutes and early in the afternoon
  • Make sure to get daily sunlight
  • Keep your room dark and cool for sleeping
  • Avoid TV, phones, and other screens before sleep or while in bed

If you are struggling with both depression and sleep problems, it is important to seek help from a doctor or therapist. There are a lot of treatments available for both conditions, and getting help is the best way to start feeling better.3

Some drugs might help manage the other symptoms of PD, which could help with your sleep. Talk to your doctor about medicine management and which options are best for you. With planning, good habits, and routines, you can help yourself get the sleep you need while living with PD.1,2

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Written by: Katie Murphy │Last reviewed: April 2022