To ensure we get a good night’s sleep, the human body has an internal clock that regulates our sleep-wake cycle. Parkinson’s symptoms can affect your sleep cycle in a variety of ways – but there are lots of things that can help.
Common sleep issues with Parkinson’s – and solutions
Pain, stiffness and involuntary movements
Talk to your doctor about medication to ease stiffness, muscle cramping, night time rigidity, and restless leg syndrome if they are keeping you awake or disrupting your sleep. Massaging your legs, doing relaxation exercises, taking a bath before bedtime or applying hot and cold compresses might improve the symptoms of cramping and restless legs too.
Parkinson’s medication not working properly
Drugs that alleviate Parkinson’s symptoms can sometimes end up interfering with sleep – because they either wear off at the wrong time, or they have side effects that keep you awake. Discuss with your doctor what best suits you and your body, and whether any changes need to be made to your medication.
Nightmares, sleepwalking and other sleep disorders
Parasomnias are a group of sleep disorders that make it difficult to stay asleep, including the process of acting out your dreams, or thrashing around in bed. This can result in injury, so it’s important to tell your doctor if you’re experiencing this. You should also make your sleep environment safer, for instance installing rails or padding to stop you falling out of bed, removing clutter in your room, or sleeping in a separate bed to your partner.
Anxiety
Sometimes changes in your brain chemistry can cause anxiety, which in turn can affect your sleep. Worries about your health can also affect your quality of sleep. Your doctor might prescribe antidepressants or refer you to a counsellor for Cognitive Behaviour Therapy (CBT) – talking about how you’re feeling with friends and family may also help.
Frequent urination
Regular night-time trips to the toilet can interrupt your sleep cycle. Some medications can cause this, as can eating salty foods or bladder infections. Your doctor might prescribe medicine to help or refer you to a continence specialist.
Insomnia
There are various causes for insomnia and not all are related to Parkinson’s. So you may benefit from keeping a basic sleep diary for a short period of time to try and identify what is keeping you awake at what times of night. Your doctor may adjust your medication, or in some cases prescribe sleeping tablets as a short-term help, but these need to be managed carefully.
Daytime sleepiness
Excessive daytime sleepiness and sleep attacks may cause you to fall asleep frequently during normal waking hours. This can sometimes be caused by Parkinson’s medication, or because you’re not getting enough sleep at night. You should try to stay awake during the day if possible as this improves the quality of night-time sleep. If you experience daytime sleepiness, take extra caution when driving, operating machinery or doing any other dangerous activities.
Turning over in bed
Lack of movement in bed caused by stiffness, muscle and/or joint pain can interrupt your sleep. Speak with your doctor, as adjusting your medication might help you manage this. You could also try satin sheets or nightclothes to make movement in bed easier.
Sleep apnea
Sleep apnea – when you stop breathing for a few seconds during sleep – occurs frequently in people with Parkinson’s and causes loud snoring or choking noises, which disturb sleep. If you wake with a headache, or if your bed partner notices any symptoms, you should speak to your doctor for a formal diagnosis and effective treatment. A machine called a PAP machine can be used to improve your breathing during the night.
How to improve your sleep environment
Just a few easy changes can help make your bedroom a more welcoming space for a good night’s sleep:
- Keep it calm, uncluttered and cooler at night. A lower temperature (16-18°C) promotes better sleep
- Do your best to sleep in total darkness (black-out blinds or curtains are good for this) but take care to have some kind of lighting should you need to get up in the night.
- Mattresses, pillows and sheets are a very personal choice – but try to buy the best-quality possible and experiment to find the style of mattress and pillow that you find most comfortable. One-way glide sheets help you move up the bed, but prevent you from also sliding down it.
- Ditch the screens! Computers, phones, tablets and televisions produce blue spectrum light, which affects your sleep quality. Avoid screens for at least an hour before bed.
- Keep a notebook and pen by your bed – if worries are keeping you awake, write them down. This can help you “switch off” and get to sleep.
Lifestyle tips to improve sleep
There are various tip and tricks – from diet to daily routine – which can improve your sleep:
Routine
Try to stick to a regular pattern of mealtimes, exercise and the time you go to bed and wake up. This will help your body clock get into the habit of sleeping.
Diet
As well as regular mealtimes, following a well-balanced mediterranean-type diet has been shown to have therapeutic effects on sleep, and its lean meats and high-fibre foods will give you all the proteins, essential vitamins and minerals you need. Eat your last meal of the day at least a couple of hours before bed to give enough time to digest it.
Fluids
Keep hydrated during the day, and try to limit caffeine drinks to the morning. And be cautious with alcohol: it might help you fall asleep, but studies show the quality of sleep is poorer. If you have bladder problems, try restricting your water intake an hour or so before bed to prevent you waking in the night.
Exercise
Moderate to intensive exercise, on a regular basis, is thought to promote sleep and reduce daytime sleepiness – and stretching exercise can also reduce rigidity. Discuss what exercise level is right for you with your doctor – see our exercise page for ideas about activities to try.
Relaxation
Allow time to unwind before bed and adopt a bedtime routine that encourages relaxation, such as having a warm bath or a massage, or listening to relaxing music.
Other treatments to improve your sleep
Non-prescription sleep and pain supplements
Various antihistamines and herbal supplements – such as those containing valerian or melatonin – have shown in some instances to improve sleep, though there have been no widespread studies. There is some emerging research to suggest that over-the-counter cannabis oil (check your country’s regulations) could improve sleep quality.
Caution! Please consult with your doctor before undertaking any non-prescription supplements.
Complementary therapies
Many complementary therapies target problems affecting sleep issues such as anxiety or rigidity and joint pain, and can also help you relax. Find out more: complementary therapies
Sleep aids and gadgets
Most sleep gadgets and apps aren’t scientifically tested, so be cautious, but some people have found them useful. You could try a white or brown noise generator, a sleep monitor app like Sleep Cycle or Oura, meditation apps like Headspace and Calm, or a dreamscape app like Pzizz. Your phone or smart watch might also have in-built sleep tools like a sleep movement tracker or wind down and sleep goals.