It's Hard to Sleep with Parkinson's Disease

More on Sleeping Problems and PD

Steve's sleep problem has reared its nasty head again.

Some sleep and some can't

As some readers know, Steve began a very low-gluten diet almost 1.5 years ago. He does not have Celiac's nor IBS but for some reason, it seemed worth a try. The result was that he found an improvement of his sleeping problems. Occasionally we will cheat or slip and a little too much gluten will find its way to his plate or glass with the resultant sleep disruption. That happened this week on a little status check.

The good news is that he says that gluten-free pumpkin pie tastes like a regular pie and I will respond that it is a regular pie with slight variations.

Steve did not have many sleep interruption issues prior to being diagnosed with PD, at least none that he would discuss or acknowledge. I do know that he would occasionally have very vivid dreams, some REM behavior, and some sinus breathing issues which he would ignore. In retrospect, the first two were alarms. What I do know is that he would fall asleep long before me and sleep through the night, oblivious to children or animals.



On a hot day, the only option

 Another thing that we saw again this winter was a slip back into dehydration. Whew! We caught it before there was a serious progression and are addressing the problem in both Steve and Harry the dog. With Harry, starting him on chicken broth will usually do it; so I'm doing that again. He also likes to take a chomp from a snow pile on his way back into the house which suggests that he might prefer really cold water in his water bowl.


 This morning I was trying to recall whether any other family four-foots had suffered similar issues. And there it was the seasonal changes which can cause horses to upset their electrolyte balance by not drinking.  Griffin, our daughter's appendix registered Thoroughbred-Quarter Horse had the problem one fall. It’s pretty easy to see a pinch of skin that doesn't retract very rapidly. What to do? You can lead a horse to...but you can't...We had to go the electrolyte route. Sprinkled over feed and in a tubed paste - it worked; and he started sucking up water again.

That beer for the Super Bowl XLV was not a good idea; it could have upset all sleep for Steve last night. Not only was there gluten, there was alcohol which is dehydrating. He was smart enough to take a gulp or two and then set it down for the evening. I should have read the lists first - what wasn't I thinking?. The information abounds for gluten-safe alcoholic beverages.

Because the sleep issues are a PD symptom, they will not vanish. Because they can be exacerbated by dopaminergic treatment, they are not going away. The most common are the levodopas (Sinemet) and ropinerole (Requip).

We often forget the association between depression and sleep problems; how do you treat your depression?


A helpful catnap

 Steve still has some prejudice against the afternoon nap, he feels he must resiste what he sees as excessive daytime sleepiness which he often feels after taking Sinemet.  Nonetheless, he knows enough to take that nap.

Occasionally he will take an aspirin before bedtime. As a NSAID, it can't hurt and for some reason - perhaps pain relief - it helps him fall asleep. We also time the Vitamin B complex to just before bedtime. If he will drink plenty of fluids (water) during the day, he can ease of in the evening. If not, I am more concerned about the dehydration than his sleep - heartless creature that I am.

The best thing that he has done is to drink a cup of unsweetened chamomile tea with a little milk. He has found that to be sufficiently relaxing to help him go to sleep.

We've read that more than 80% of PwPs have sleep disorders or sleep dysfunction ranging from insomnia, excessive daytime sleepiness, and the parasomnias which include: sleep talking and walking, REM behavior disorders, sleep terrors. We have read about sleep apnea issues which should also be considered. There are CPAP (continuous positive air pressure) machines which can help. We;ve read and tried memory foam mattresses and Steve's favorite, the heated mattress pad, which is more effective for him than a heated blanket.

Oh for a Cat Nap



I'm over-the-top about some things but in treatment, I prefer the less is more approach to start. I'd like him to try breathing exercises again to help him relax before bedtime but since he is no linger having swallowing problems, he bristles at the words exercise and sleep in the same sentence. Still, I think they might help to release the tension and frustrations of the day. I cannot stress enough the importance of healthy breathing habits.

We are interested in hearing from others about what works for them...even the medications that work. We are also interested in hearing about things that worked for awhile even if they stopped working.

additional reading:

A must read by Dr Robert A Hauser etal