The Parkinson’s Disease Society estimates that around one in 500 people have Parkinson’s disease with 10,000 diagnosed in the UK each year. Although symptoms generally appear after the age of 50, one in 20 of those diagnosed each year are under 40 with men slightly more likely to develop the disease than women.
Parkinson’s disease is a progressive neurological condition. The disease develops when part of the brain, the substantia nigra, starts to lose the nerve cells that produce dopamine, the chemical responsible for transmitting messages to the parts of the brain that coordinate movement.
The main symptoms affect movement and result in tremor, often beginning in one hand, and difficulty moving. Muscles may become stiff or rigid making movements such as standing up or getting out of bed difficult. Other symptoms include constipation, urinary urgency and depression. Sleep disturbance and difficulty staying alert are also reported by many sufferers as the condition progresses.
Reasons for Insomnia
There are a number of reasons why people with Parkinson’s disease have difficulty sleeping and a recent survey showed that up to 90 percent of sufferers experience some problems. These may be related to symptoms related to the disease, as a response to prescribed medication or the depression and anxiety that may result from coping with symptoms or not getting sufficient rest.
Cramps during the night may cause early waking and muscle spasms cause pain and difficult in moving. Needing to urinate is another common problem but this is not always easy if it is difficult to move or get out of bed.
Medication prescribed to replace dopamine may start to wear off during the night causing pain, tremors and other symptoms which result in early waking and disturbed sleep.
Sufferers are also prone to parasomnias and may experience nightmares, sleep walking and distressing behaviour such as shouting and violent reactions.
Parkinson’s disease is also associated with Restless Leg Syndrome and other uncomfortable muscle spasms or ‘pins and needles’ making it difficult to relax and causing stress and anxiety.
Coping with symptoms, adjusting to medication and lack of sleep can all result in depression and anxiety, making bedtime distressful as sufferers anticipate sleeplessness and the onset of symptoms.
Lack of sleep can result in daytime sleepiness and caution should be taken when driving or operating machinery. Drug therapy to help facilitate a restful night and encourage alertness during the day should be discussed with a GP. In particular, incidences of sudden onset of daytime sleepiness should be raised as there may be the need to prescribe drugs that help patients stay awake.
Suggestions to Improve Sleep
Sufferers should also follow the advice on other parts of this site relating to diet, exercise and relaxation. Caffeine, alcohol and stimulating activity should be avoided in the hours before bedtime. Liquids should also be reduced before bedtime and if night time urination is difficult, a commode may be worth considering…
Exercise should be taken earlier in the day and gentle stretching, massage and a warm bath may help with the muscle discomfort. A regular routine that may be adjusted to work with medication should be adopted and this may mean earlier bedtimes and an acceptance of early rising.
It is also important to discuss any difficulty sleeping or disturbances with the GP or nurse as they will be familiar with the problems and will be able to suggest ways to help. Sleep is important, so take action, ask for help and start to look forward to a relaxing night…