Sleep problems and conditions in Parkinson's

Insomnia is a sleep disorder that causes problems getting to sleep or staying asleep at night, so you are likely to feel tired during the day.

If you’re having trouble sleeping, a cycle can develop. If you can’t get to sleep, then you can become irritated, fed up, or even anxious about how you will cope the next day. These feelings tend to make you more alert, which keeps you awake, and so on. For many people, this is the start of insomnia.

Symptoms

Symptoms of insomnia are common in most long-term conditions.

People with Parkinson’s can be more prone to insomnia because of Parkinson’s symptoms, such as tremor, stiffness, pain and restless legs syndrome, that can all disturb sleep.

Some medications can act as stimulants and keep you awake. Speak to your GP, specialist or Parkinson’s nurse for advice about Parkinson’s symptoms or medication if you think these are stopping you from sleeping.

Find out more about medication and sleep.

Nocturia is waking up at night with the urge to urinate, which can be a common problem for people with Parkinson’s. If this urge happens during an ‘off’ period (when your medication isn't fully active), some people find that they can’t control their bladder and can’t get to the toilet in time.

There are other possible causes of nocturia, such as a bladder infection.

Some medications can cause nocturia, for example some anti-depressants or medications for high blood pressure.

If you are experiencing this problem, speak to your GP, specialist or Parkinson’s nurse to work out the cause of your nocturia. They can suggest ways to treat and manage the issue. You may also be referred to a continence advisor – a specialist nurse who assesses and manages incontinence.

If you are having problems sleeping because of an increased urge to pass urine at night, you can try the following:

• For bladder problems, it is important not to cut down too much on the amount of fluid you drink. That may leave you dehydrated and may make the bladder more irritable. But try and reduce the amount you drink in the evening and make sure you have been to the toilet before you get into bed.
• Avoid drinking alcohol or caffeine-containing drinks, such as coffee and tea, in the evening, and try to limit these during the day generally.
• Use bed protection, such as absorbent sheets and bed pads, just in case. Appliances such as handheld urinals or sheaths may also help you if you are having problems getting to the toilet.

‘Jumping’ of the legs, arms or body during sleep is not uncommon in Parkinson’s. It’s known as ‘periodic leg (or limb) movements’. Some people get it with restless legs syndrome, but it can happen on its own.

It responds well to treatment with levodopa and dopamine agonists. Speak to your health professional for advice.

This is also known as daytime hypersomnolence. Parkinson’s medications can cause excessive daytime sleepiness or sudden onset of sleep. This can be severe.

This may be more likely in people with later stage Parkinson’s who are on multiple medications. It can also occur when increasing medication, particularly dopamine agonists.

Excessive feelings of sleepiness during the day can also happen if you’re not getting enough sleep at night. The effect can cause people to fall asleep or doze off during normal waking hours.

In some cases, it can even lead to the sudden onset of sleep. This can be dangerous if you are doing certain things, such as driving or operating machinery.

Medication may help, so speak to your GP, specialist or Parkinson’s nurse.

Sleep apnoea is a serious condition where a person momentarily stops breathing while asleep. This makes the person wake up, take a few breaths and go back to sleep again.

The person has no memory of this happening, as it’s so brief, but it disturbs their sleep.

Symptoms of possible sleep apnoea include loud snoring, choking noises while asleep or excessive daytime sleepiness. If you or your bed partner notice any of the symptoms, you should seek treatment from a sleep specialist.

Get more advice about sleep apnoea in the UK.

At night or early in the morning, you may also experience problems with:

• Low blood pressure
• Dystonia
• Restless legs syndrome
• Akinetic pain