Sleep disturbances are one of the common issues that plague people with Parkinson's disease.
Problems such as insomnia, frequent awakenings, involuntary movements during the night and, in some cases, excessive daytime sleep episodes, can worsen quality of life, affecting both physical and psychological well-being. Managing these symptoms is critical to maintaining optimal health, and numerous studies have identified useful strategies. In this article, we will explore the main types of sleep disorders associated with Parkinson's and ways to address them, with a focus on behavioral techniques, drug therapies, and the importance of maintaining a regular routine.
Major sleep disorders in Parkinson's disease
Parkinson's disease often involves a variety of sleep-related problems, which may differ in intensity and frequency. Some of the most common complaints include. insomnia, restless legs syndrome, REM sleep behavioral disorder (RBD), and daytime sleepiness.
Insomnia manifests itself mainly with difficulty falling asleep or with nocturnal awakenings, often caused by the muscle rigidity and tremors that characterize the disease.
Restless legs syndrome is characterized by a feeling of discomfort in the legs that leads to involuntary movements, making it difficult to rest at night.
Finally, the behavioral disorder of REM sleep is a condition in which the person performs physical movements or makes sounds while dreaming, due to a loss of muscle paralysis during the REM phase of sleep. These disorders require close monitoring and targeted interventions.
Nonpharmacological strategies to improve sleep
Nonpharmacological strategies to deal with sleep disturbances in Parkinson's are often effective and recommended as a first approach because they carry no risk of side effects. These include, sleep hygiene plays a key role: maintaining a regular routine, avoiding prolonged afternoon naps, limiting the use of electronic devices before bedtime, and creating a relaxing and comfortable sleeping environment are useful practices for improving sleep quality.
Relaxing activities such as meditation or deep breathing can help reduce anxiety and muscle tension.
Cognitive behavioral therapy for insomnia (CBT-I) is another approach that has proven useful, as it teaches techniques for changing negative sleep-related thoughts and replacing them with positive habits.
Drug therapies and medical interventions
In some cases, nonpharmacological strategies are not enough, and pharmacological treatments may be necessary. However, the management of sleep medications in patients with Parkinson's disease can be complex, as Some medicines may interact with antiparkinsonian drugs or cause unwanted side effects.
Hypnotic drugs, for example, are used with caution because of the risk of excessive sedation. Other treatments include. melatonin and clonazepam, which have been shown to be helpful in reducing the symptoms of REM sleep behavioral disorder. It is always important to follow the neurologist's instructions, who can adjust the therapy according to individual needs and monitor any side effects.
The role of physical activity and diet
Recent studies suggest that Regular physical activity and a balanced diet can have positive effects on the sleep of people with Parkinson's disease. Exercise, when practiced during the day, helps reduce muscle stiffness and improve mood, two factors that can positively influence sleep quality.
The aerobic exercises, yoga and physical therapy are especially recommended. Regarding nutrition, avoid heavy foods and exciting drinks before bedtime can reduce digestive discomfort and facilitate deeper rest. The choice of a diet rich in antioxidants and vitamins supports overall health and can help limit inflammation and oxidative stress, which can negatively affect sleep.
Addressing sleep disorders related to Parkinson's disease requires an integrated approach that combines behavioral, pharmacological, and healthy lifestyle interventions. Each patient is unique, and what works for one may not be effective for another; therefore, it is essential to collaborate with a medical team that can assess individual needs and tailor the treatment plan. With the right support, people with Parkinson's can improve the quality of their sleep, thereby also promoting better management of daytime symptoms and a higher quality of life.
Sources:
- Rodrigues TM, Castro Caldas A, Ferreira JJ. Pharmacological interventions for daytime sleepiness and sleep disorders in Parkinson's disease: Systematic review and meta-analysis. Parkinsonism Relat Disord. 2016;27:25-34.
- Dean, M.N., Amara, A.W.. Clinical Trials for Sleep Disorders and Daytime Somnolence in Parkinson's Disease. Neuromethods. 2021;160: 271-291
- Xu, Z., Anderson, K.N. & Pavese, N. Longitudinal Studies of Sleep Disturbances in Parkinson's Disease. Curr Neurol Neurosci Rep. 2022;22:635-655
- https://www.fondazioneveronesi.it/magazine/articoli/neuroscienze/un-sonno-troppo-agitato-puo-anticipare-la-malattia-di-parkinson
- Lauretani F, Testa C, Salvi M, Zucchini I, Giallauria F, Maggio M. Clinical Evaluation of Sleep Disorders in Parkinson's Disease. Brain Sciences. 2023; 13(4):609.
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