How medication used to treat Parkinson's disease can impact sleep

Introduction

Introduction

It's no secret that Parkinson's disease can greatly impact your sleep, but did you know that the medication used to treat it can also affect your slumber? If you or someone close to you is struggling with this condition, disrupting their much-needed rest, this blog post is for you.

We will provide insight into how different types of treatment might influence their sleep disorder habits and offer some guidance on how they may combat any adverse effects.

So, if disturbed nights are something you or a loved one are grappling with due to Parkinson's Disease and its accompanying medications, read on – we have some helpful answers!

What is Parkinson's disease?

Parkinson's disease is a movement disorder caused by the death of dopamine-producing cells in the brain. It typically manifests through motor symptoms such as shaking, stiffness, difficulty walking, and balance problems. Non-motor symptoms can include depression, trouble sleeping, and memory difficulties.

When referring to Parkinson's disease, "motor symptoms" is a term healthcare providers use for any indication that makes it difficult for you to move or control your movements. These are the most easily recognizable signs of PD.

Parkinson's motor symptoms encompass stiff muscles, uncontrollable tremors in your hands or legs, balance and coordination difficulties, and slower-than-usual movements (bradykinesia). In addition to these physical issues, the disease can lead to various non-motor concerns.

These may include emotional changes such as altered moods, sensory disturbances like impaired sense of smell or vision, and other potential effects that impact both body and mind alike.

What's the relationship between Parkinson's and sleep?

Parkinson's disease is a neurological disorder that can cause severe mobility issues and difficulty with coordination.

Sleep disturbances are another common symptom of Parkinson's, especially problems falling asleep or staying asleep for long periods. Research has found that about two-thirds of people with Parkinson's experience poor sleep quality.

Medication used to treat Parkinson's can also have an impact on sleep. Dopamine agonists, of drug commonly used to manage Parkinson's symptoms, can increase wakefulness and reduce the amount of time spent in deep sleep.

Other medications, such as anticholinergic drugs, can have the opposite effect and cause excessive daytime drowsiness.

It's important to talk to your doctor if you're experiencing sleep problems due to Parkinson's. They can recommend lifestyle changes or medications that may help improve the quality of your sleep.

How medication used to treat Parkinson's disease can impact sleep: 10 Problems and Solutions

Parkinson's disease can cause a variety of symptoms, including sleep problems. As with other aspects of Parkinson's treatment, the best approach may be combining medications, lifestyle adjustments, and other therapies. Common sleep problems associated with Parkinson's disease—and how to address them—include the following:

1. Drugs Used to Treat Parkinson's Disease

Parkinson's disease medications, such as levodopa, dopamine agonists, and anticholinergics, can cause sleep issues.

These drugs can lead to difficulty falling asleep or staying asleep, vivid dreams or nightmares, faster-than-normal thinking and talking for a brief period (called "on" periods), sleep attacks (sudden, irresistible episodes of sleep), or other unwanted behaviors during sleep (such as wandering).

Fortunately, several strategies can help minimize these medications' effects on sleep. For instance, Parkinson's drugs may be adjusted or timed differently to minimize their effect on your sleep.

Doctors may also prescribe additional medications, such as sedatives or melatonin, to help sleep.

2. Restless Leg Syndrome (RLS)

Restless leg syndrome is a neurological disorder characterized by an uncontrollable urge to move one's legs. Symptoms may be worse at night and can disrupt sleep.

Doctors may prescribe dopamine agonists or anticonvulsants to treat RLS in people with Parkinson's disease and lifestyle changes such as avoiding stimulants like caffeine before bedtime.

3. Sleep Apnea

Sleep apnea is a disorder that causes brief interruptions of breathing during sleep. People with Parkinson's disease may be at higher risk for sleep apnea, leading to excessive daytime sleepiness, morning headaches, and overall decreased quality of life.

A doctor may recommend lifestyle changes such as maintaining a healthy weight, sleeping on your side instead of your back, and using breathing devices such as CPAP (continuous positive airway, continuous positive airway pressure) to treat sleep apnea.

Treating your sleep apnea

Treating your sleep apnea may also help with other common sleep problems among Parkinson's patients. It is important to talk to your doctor about any medications you take, as they can impact sleep apnea.

Some medications to treat Parkinson's disease may worsen sleep apnea, so discussing all options with your doctor is important.

Some lifestyle changes may also be helpful, such as limiting caffeine and alcohol intake, avoiding large meals late in the evening, and establishing a relaxing bedtime routine. Additionally, taking breaks for rest or light exercise throughout the day may reenergize youze.

4. Depression

Depression is common among people with Parkinson's disease, and it can lead to insomnia or fatigue. Treating depression may help improve sleep. This may include talk therapy, medications, exercise, and other lifestyle changes.

5. Sleep Fragmentation

The constant movement that often accompanies Parkinson's can lead to sleep fragmentation, which disrupts the normal pattern of deep brain stimulation and light sleep.

People with Parkinson's may benefit from lifestyle modifications such as avoiding caffeine and alcohol late in the day, setting a regular bedtime routine, and using relaxation techniques such as deep breathing or mindfulness.

Medications for Sleep Fragmentation

In some cases, medications may be necessary to help with sleep fragmentation. Several classes of drugs are used to treat the symptoms of Parkinson's, including dopaminergic medications, anticholinergics, and benzodiazepines.

Some of these drugs can cause side effects such as confusion or excessive drowsiness, disrupting sleeDiscussinguss the potential side effects of any medications with your doctor is important to finding the best treatment plan.

In addition, certain medications used to treat Parkinson's can affect sleep in other ways. Some dopaminergic agents, such as levodopa, can cause involuntary movements (called dyskinesias) during the night.

6. Stress and Anxiety

Stress and anxiety can also cause difficulty sleeping, especially among people with Parkinson's. Stress management techniques such as yoga, deep breathing, and meditation can help reduce stress and improve sleep.

7. Insomnia

Insomnia is common among people with Parkinson's and can become a chronic problem if left untreated.

A doctor may recommend lifestyle modifications such as avoiding caffeine and nicotine late in the day, setting a regular bedtime routine, using relaxation techniques, and cutting back on daytime naps.

Medications such as melatonin and low-dose tricyclic antidepressants may also help.

Insomnia treatment and Parkinson's medications

Certain medications used to treat Parkinson's disease can also affect sleep. Dopamine agonists, such as pramipexole and ropinirole, can cause sleep attacks during the day and insomnia at night.

Anticholinergics, such as trihexyphenidyl and benztropine, can cause sleep disruption and confusion. Medical professionals may suggest adjusting the dosing of the medication or changing medications to reduce the impact on sleep.

If a medication adjustment is made, it should be done in coordination with the doctor, and their instructions should be followed closely.

Additionally, medical professionals may recommend medications that are not specifically used to treat Parkinson's but can help with sleep. This includes non-benzodiazepine medications, such as zolpidem, eszopiclone, and ramelteon, which can treat insomnia.

It is important to speak with a doctor before starting any new medications and discuss the potential benefits and side effects.

8. Nighttime urinary frequency

Parkinson's disease can cause changes in bladder control, leading to a need to get up frequently during the night to use the bathroom. This can be caused by a combination of the disease or medications used to treat Parkinson's.

If you take medication for Parkinson's, your doctor may adjust the dosage or timing of your dosage to help reduce its effect on nighttime urination.

9. REM behavioral disorder

People with Parkinson's may experience rem sleep behavior disorder, characterized by violent body movements or vocalizations during REM sleep. It is caused by a dopamine deficiency, which helps regulate muscle movement and emotional responses.

Medications used to treat Parkinson's disease may contribute to RBD symptoms, as they can lead to an imbalance in the brain's dopamine levels and other neurotransmitters.

It is important to talk with your doctor about how your medication might affect your sleep, as it can be treated with changes in medication or other therapies. It is also important to maintain healthy sleep habits to reduce the risk of developing RBD. Examples include:

• Avoiding caffeine and alcohol before bed.

• Avoiding screens an hour before sleep.

• Exercising regularly.

Getting help from a professional is also important if you struggle to manage your sleep.

With the right treatments and lifestyle changes, it is possible to reduce the occurrence of REM behavioral disorders in those with Parkinson's.

10. Nighttime Hallucinations, Psychosis, & Confusion

Nighttime hallucinations, psychosis, and confusion can be common in people living with Parkinson's disease. A combination usually causes these symptoms, including the effects of Parkinson's and the medications used to treat it.

Dopaminergic drugs often prescribed for nighttime use can alter the dream-sleep cycle and cause insight, confusion, and psychosis. However, these symptoms can usually be managed with medication adjustments and other therapies.

It's important to talk to your doctor if you experience any of these side effects. They can provide guidance and support in managing them.

How are sleep problems treated in people with Parkinson's disease?

Your healthcare provider will suggest treatments that address your sleeping issues. Depending on the case, they may:

Change your medication:

Medication used to treat Parkinson's disease can affect sleep. If your doctor believes that is the case, they may suggest changing it.

Refer you to a sleep specialist:

Sleep problems can be caused by other medical conditions such as sleep apnea, insomnia, and parasomnias. A sleep specialist can diagnose and treat those conditions if necessary.

Prescribe a new medication or therapy: 

If you're suffering from a slumber-related issue, your healthcare provider will assess the best approach for relief. Medication might be prescribed as part of your treatment plan in some situations. For instance, those with sleep apnea may find aid in wearing a customized oral appliance that allows oxygen to flow consistently and prevents abrupt gasps while sleeping.

Suggest lifestyle changes:

Daily, your habits and bedroom atmosphere can assist or hinder your sleep. To get the best rest possible, try setting a consistent bedtime routine, keeping the room dark, and abstaining from electronics before bed. If you struggle with REM sleep disorder, speak with your doctor about what methods will most benefit protecting yourself (and those around you) while sleeping.

What else can I do to sleep better with Parkinson's disease?

Establishing quality "sleep hygiene" habits can be beneficial in ensuring more restorative sleep.

Do:

• Get up and go to bed at the same time each day

• Exercise regularly, but not too close to bedtime

• Limit caffeine, alcohol, and nicotine

• Avoid large meals before bedtime

Don't:

• Rejuvenate and restore your energy with extended daytime naps.

• Limit your consumption of stimulants, such as caffeine, to no later than six hours before bedtime.

Instead of using your bedroom solely for sleeping, try changing the environment by relocating to another room.

How common are sleep problems for people with Parkinson's?

Sleep problems are quite common among people with Parkinson's disease. It is estimated that 80–90% of people with Parkinson's experience some form of sleep disruption, including difficulty falling asleep or staying asleep (insomnia), sleeping too much during the day (excessive daytime sleepiness), or having unusual dreams or movements during sleep.

When should I call my healthcare provider?

If you are taking medication to treat Parkinson's disease and notice changes in your sleep pattern, talking with your healthcare provider is important.

Your doctor may need to adjust the dosage of your medication or prescribe a different treatment plan to better manage your symptoms and improve your sleep quality.

Also, be sure to tell your healthcare provider if you are experiencing any unwanted side effects of your Parkinson's disease medication, such as sleep disturbances. While certain medications can help to improve the symptoms of Parkinson's, they can also make sleeping more difficult.

This is because some medications used to treat movements associated with Parkinson's can increase daytime alertness and interfere with sleep-promoting hormones, leading to insomnia.

Your healthcare provider can help you determine if your medication affects your sleep and work with you to find the best treatment plan to address your symptoms.

Making lifestyle changes, such as avoiding caffeine and alcohol in the evening, exercising regularly, and practicing relaxation techniques, can also help to improve your sleep.

FAQs

How does levodopa affect sleep?

Levodopa, the most commonly prescribed medication for Parkinson's disease, is a dopamine replacement therapy. Dopamine is a chemical messenger in the brain that plays an important role in motor control and can be diminished with Parkinson's disease.

Levodopa helps to restore dopamine levels, improving motor function and helping people with the condition manage their symptoms.

However, levodopa can disrupt sleep by interfering with circadian rhythms or causing sudden awakenings at night. It is also known to cause vivid dreams and even sleep disturbance.

What medication helps Parkinson's patients sleep?

Common medications used to help people with Parkinson's disease include benzodiazepines, antiepileptic drugs, and melatonin. Benzodiazepines, such as lorazepam and clonazepam, help reduce anxiety while promoting sleep.

Antiepileptic drugs such as gabapentin and pregabalin can also help to ease muscle rigidity, allowing for better multiple sleep latency tests. Finally, melatonin helps to regulate the body's day/night cycle and can help to improve sleep quality.

How does Parkinson's disease affect sleep?

Parkinson's disease can have a significant impact on sleep. Symptoms such as tremors and rigidity can make getting comfortable and falling asleep difficult. Additionally, fluctuations in dopamine levels can lead to difficulties maintaining sleep or cause sudden awakenings during the night.

Finally, the side effects of medications used to treat Parkinson's Disease sleep scale, such as levodopa, can further disrupt sleep. For these reasons, people with Parkinson's need to talk to their doctor about strategies and medications to help them get a better night's restful sleep.

Why does levodopa cause insomnia?

Levodopa disrupts sleep by interfering with the body's circadian rhythms or causing sudden awakenings at night. It can also cause vivid dreams and even sleepwalking. These side effects can disrupt sleep quality, leading to difficulty falling or staying asleep.

To help manage these effects, people with Parkinson's should talk to their doctor about strategies and medications to help them get a better night's obstructive sleep apnea.

Conclusion 

To conclude, managing Parkinson's disease can sometimes be challenging. Balancing medications with other treatments, establishing healthy sleep habits, and avoiding unhealthy lifestyles are essential for maintaining the quality of life.

Knowing how medication used to treat Parkinson's can influence your sleep continuity can help you manage motor symptoms more effectively and understand how to adjust medications to improve your overall well-being.

Finally, don't hesitate to ask your doctor any questions or concerns. A doctor can assess your situation and provide advice tailored specifically to you so that you can continue living an active and fulfilling life while dealing with this complex condition.