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Sunday, November 6, 2016

How can Parkinson's affect my sleep?



Parkinson’s can have many different effects on your sleep, including trouble falling or staying asleep, vivid dreams, waking up frequently during the night and excessive sleepiness during the day. Like other non-motor symptoms, sleep problems can appear before the motor symptoms.
An estimated 30% of people with Parkinson’s experience some combination of insomnia (trouble falling asleep) and sleep fragmentation (waking up frequently during the night). Studies have shown people with Parkinson’s have different sleep patterns and that their deepest periods of sleep during the night are shorter and interrupted more often than people without Parkinson’s. Often this is made worse by medications that may wear off in the night, causing tremor, painful stiffness or other symptoms to return and disrupt your sleep.
Anxiety, depression nighttime sweating and trouble moving in bed are other Parkinson’s symptoms that can make getting a good sleep difficult. Fragmented sleep is also exacerbated by how often some people with Parkinson’s find themselves waking up often during the night to use the toilet because of the changes in the bladder that come with Parkinson’s.
Occasionally medications used for Parkinson’s, including dopaminergic medications like carbidopa-levodopa (Sinemet®  ) and select antidepressants and sleep aids, can cause vivid dreams or nightmares and disrupt your sleep. As unsettling as these can be in and of themselves, this can present serious concerns when combined with another possible effect of Parkinson’s on sleep called Rapid Eye Movement Sleep Behavior Disorder (RBD), when the natural processes that prevent you from acting out your dreams with movement stop working. As a result, a person with RBD might yell, scream, kick or get out of bed to “act out their dreams.”
Typically, individuals with RBD report that these dreams are very vivid and that they do not feel rested in the morning.  The bed partner often reports violent responses by the person with RBD, which involved being punched, bitten or kicked, while the person acting out the dream is unaware of this behavior. If you or your loved one is experiencing RBD, discuss with your doctor. There are possible medications that can help as well as adaptations and modifications to beds and bedrooms to enhance the safety for the person with Parkinson’s as well as their partner. Some couples living with Parkinson’s discover the safest and most effective way to ensure both partners sleep safely and as soundly as possible is to sleep in separate beds.
Restless legs syndrome (RLS) is common in people with Parkinson’s and can present another interruption to a good night’s sleep. RLS is characterized by unpleasant feelings in the legs when they are at rest that is usually relieved with movement. RLS can result from medications and medical conditions other than Parkinson’s, so definitely discuss with your doctor if you are experiencing RLS.
Other non-Parkinson’s-related issues such as sleep apnea, pauses in breathing or shallow breaths during sleep, can make sleep problems worse. While sleep apnea is not more common in people living with Parkinson’s, it does occur more frequently in adults as they age.
Many people with Parkinson’s also experience excessive daytime sleepiness, which can be caused by the various effects of Parkinson’s that interrupt sleep at night as well as from side effects of some Parkinson’s medications.

WHAT YOU CAN DO RIGHT NOW TO LIVE WELL

There are several medications and other treatments available for many of the sleep challenges Parkinson’s can bring that should be discussed with your doctor. Making changes to your diet, lifestyle, bedroom and pre-sleep routines can also help improve your ability to fall and stay asleep. Exercise during the day and gentle stretching can help and even seemingly small changes, like switching the fabric of your pajamas or sheets, may improve the quality of sleep. Meditation is another relaxation technique that can help to quiet the mind before you go to sleep.
You may also consider seeing a sleep specialist about specific sleep challenges. Sleep specialists typically work in actual sleep clinics or as part of multidisciplinary medical teams at hospitals.
Learn about changes you can make to your diet, lifestyle and bedroom to help improve your quality of sleep:
Work Sheet
 Sleep hygiene
  • Remove TV and computer from bedroom, keep the room dark and use nightlights that can easily be turned on.
  • Set a routine bedtime and waking time by going to bed and getting up the same time of day each evening and morning.
  • Avoid action TV shows, video games or anxiety-provoking activities (this is not the time to pay your bills!) before bed. Try relaxing music, gentle stretching, aromatherapy, meditation and massage before bed.
  • Avoid bright lights at night. Amber-tinted computer screens can reduce the impact of computer screens.


Dietary changes
  • Avoid stimulants such as caffeinated drinks after 3 p.m. Avoid alcohol or limit to one glass.
  • Avoid heavy, starchy meals or snacks before bed. Try foods with tryptophan such as poultry and milk.


Lifestyle changes
  • Take a warm bath to relax before bedtime.
  • Limit catnaps during day to 10 to 20 minutes before 3 p.m.
  • Avoid heavy exercise at night, but do exercise daily.


Bed comfort
  • Use silk pajamas or sheets if you have trouble turning.
  • Examine your mattress. Has it seen better days?
  • An occupational therapist can help with bed comfort.


Treatment
See your doctor to optimize motor control and Parkinson’s medicines.
Depression, anxiety, pain, restless leg syndrome, vivid dreaming, incontinence and sleep apnea can be treated. Discuss with your doctor.
A sleep study may be needed to diagnose sleep apnea if you snore.
Sleep medicines can cause daytime sleepiness, confusion and weakness. You may not need them if you develop good sleep habits.

 See Video :   https://vimeo.com/176605671


http://www.davisphinneyfoundation.org/parkinsons-101/non-motor-symptoms/?gclid=Cj0KEQjwqfvABRC6gJ3T_4mwspoBEiQAyoQPkXReQDoZvb5IF5hw9-DRFPbvq6JIEnnxRZUkzXqQkcMaAgiP8P8HAQ

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