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The community that never sleeps

The Parkinson’s community, like New York City, never sleeps. No matter what time it is where you are, you can find fellow Parkies on line posting news, sharing fears, seeking answers, and debating relevant and not so relevant issues of the day. We are instant messaging, e-mailing, and writing long diatribes for message boards and list serves… none of which are conducive to preparing to sleep.   The overwhelming majority of people with Parkinson’s (PWP) experience sleep disturbances. These include, but are not limited to, an inability to fall asleep or stay asleep, excessive daytime sleepiness, “sleep attacks,” vivid dreams, and jerking, involuntary movements of limbs (Restless Leg Syndrome). These disturbances can result from depression, medication, stiffness and difficulty turning over, and a frequent urge to urinate. Identifying the underlying cause(s) is key to finding an effective treatment.   Sleep disturbances negatively impact quality of life more than the well-known motor symptoms associated with Parkinson’s disease. Sudden “sleep attacks,” linked to treatment with the newer dopamine agonists, interfere with daily activities, compromising safety behind the wheel and in the workplace, and jeopardizing independence.   Individual sleep needs vary, but the average, healthy adult needs eight hours of sleep a night to function optimally. Studies have shown that healthy individuals who are sleep-deprived are less efficient and more irritable, and often experience reduced short-term memory capacity and impaired judgment. So, what can be expected of Parkies who are lucky to get four hours of sleep per night? Sleep is essential for our health and well-being. When we sleep well, we wake up feeling refreshed and alert; and we look, feel, and perform better. Sleep also contributes to a healthy immune system, and helps regulate the levels of hormones that play a role in making us feel hungry and full.    This explains why I hear Ben and Jerry whispering my name in the dark of night and am unable to resist eating cherry Garcia straight out of the carton. In the morning light, faced with the sight of empty boxes and wrappers, I must admit that edema is not the sole cause of my weight gain.   While there are many prescription and over the counter sleeping pills, all have potentially adverse side effects, and should be taken only after consulting your doctor and pharmacist about possible interactions with other medications you are taking. Research indicates that sleeping pills quickly lose their effectiveness and should be used only intermittently.

An alternative suggested by many PWP is Melatonin, a hormone secreted in the normal brain that helps regulate sleep, has no significant short-term side effects, and can be purchased over the counter. Improve quality and quantity of your nighttime sleep: Maintain a regular bed and wake time schedule, including weekends. Establish a relaxing bedtime routine (soak in a hot bath, read, listen to music). Avoid activities that can cause excitement or stress like paying bills or engaging in competitive games. Create a sleep-conducive environment that is dark, quiet, comfortable, and cool. If necessary, consider using room darkening shades, ear plugs, "white noise," humidifiers, fans and other devices. Be sure your mattress and pillows are comfortable and supportive. Exercise regularly in the late afternoon. Avoid caffeine (e.g. coffee, tea, soft drinks, chocolate), nicotine, and alcohol within 6 hours of your regular bedtime. www.ohsu.edu/.../handbook_sleep.pdf   Sheryl wrote this article. I had to laugh to myself when I checked my email at 1:30a.m. - Sheryl had sent the article at 3:30a.m. her time. It was a sleepless night for her when she sent it - and yet another sleepless night when I received it. We often exchange a flurry of emails in the wee hours - but avoid using the phone to not disturb my sleeping husband!   top

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