“Goodnight, Mama. I love you.”
I get this message every day around 3:30 p.m., on my cell phone. It’s my daughter saying goodnight from Italy where it is 12:30 am. When she is home, we hug each other every night as we go to bed. Or, when I go to bed, as she is a night owl.
We all need our sleep. Not a profound statement. But when you have Parkinson’s or you have a Parkinson’s patient in your home, sleep can become rare and precious. I remember getting up several times a night to check on my Burt, and find him wide awake, staring at the ceiling.
Paul, a Person With Parkinson’s (PWP), says, “I wake up 3–5 times a night.”
Sleep can be disrupted for many reasons, and problems can be categorized as trouble falling asleep or trouble staying asleep. Early morning awakening with fragmented sleep is the most common sleep problem in Parkinson’s, according to Dr. Monique Giroux, a medical resource for the Davis Phinney Foundation for Parkinson’s. Other causes of early awakening include depression, anxiety, pain, tremor, trouble moving in bed, nighttime sweats and bladder problems. Trouble falling asleep is usually caused by pain, movement problems, anxiety restless leg syndrome, watching TV or using a computer at night.
But Paul shares that he doesn’t wake up much “after vigorous exercise. I always sleep better if I’ve done a long walk or something like that during the day. Exercise is critical to staying on top; do as much as you can for as long as you can.”
This is one PWP that practices what this column has been “preaching.” Exercise is paramount in Parkinson’s for so many reasons. Sleeping better can be at the top of that list. It’s no secret what being rested can do – both for the patient and the caregiver.
Following is a “worksheet” from the Davis Phinney Foundation regarding sleep and insomnia:
Remove TV and computer from the 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 at 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. I recall a time when I was in the hospital and a nurse gave my roommate and me massages to help us sleep. She would say, “This is to make your eyelashes go down.”
Avoid bright lights at night. Amber-tinted computer screens can reduce the impact.
Avoid stimulants such as caffeinated drinks after 3 p.m. Avoid alcohol or limit to one glass.
Avoid heavy, starchy meals or snack before bed. Try foods with tryptophan such as poultry or milk.
Take a warm bath to relax before bedtime.
Limit catnaps during the day to 10 or 20 minutes and before 3 p.m.
Avoid heavy exercise at night, but do exercise daily.
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.
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.
I had a question about the use of Sinemet (carbidopa/levodopa) in relation to eating protein. We have discussed this before, but to make sure I had the right information, I called the National Parkinson’s Foundation. The answer: do not eat protein two hours before you take Sinemet, or one hour after. It compromises the efficacy of the drug.
And now, it’s time for bed. Goodnight, Daughter. I love you.