Sleep disruption in Parkinson’s disease is a common concern for most of my patients.
Daytime sleepiness can ruin an entire day, even worse if it becomes your new normal. Sleep disruption can exacerbate motor symptoms, worsen mood, and accelerate cognitive decline affecting attention and concentration.
As a neurologist, my goal is to understand WHY patients are suffering from daytime sleepiness by asking questions instead of jumping to a pill. Many prescription medications for insomnia have relatively weak data. It is important to review your own sleep story, so you and your neurologist can directly treat the problem.
For instance, I ask questions like “What keeps you up before sleep?” “Stressed?” “Nighttime allergies?” “Snoring?” “What do you eat/drink before bed?” “Nighttime urination?” “Are you in pain or too stiff?” “Tremor?”. If somebody just can’t turn their brain off before sleep (i.e. worrying, planning, etc…) then I would strongly consider using relaxation techniques and/or cognitive behavioral therapy.
Cognitive behavioral therapy for insomnia (CBT-I) is generally agreed to be first line therapy for insomnia by sleep specialists. Dedicating time to this is tough work, but it can prove to be safest and most beneficial. You can use a traditional therapist or even apps such as CBT-I Coach, Stellar Sleep, and Sleepio.
Sometimes it’s not so easy to identify why you wake up spontaneously at 2am since Parkinson’s disease can affect our sleep centers in the brain. So, try using sleep journals or be more mindful of your sleeping habits.
Although there are medications you can try, please consider these other safer, natural approaches including meditation, deep breathing exercises, white noise, essential oils, yoga nidra, regular morning exercise, and ensuring a cool environment with no screen time.
Understanding sleep is not easy, but relaying your symptoms to a physician should be since it can result in better directed treatment.