For people with Parkinson's disease, insomnia is a very common sleep disorder. The medication, the disease itself and the age of the patient all increase the likelihood of insomnia.
Parkinson's disease is a disorder of the central nervous system. Patients have a variety of symptoms including tremors and rigid muscles. As the disease progresses, the symptoms become worse, eventually making it very difficult for the patient to stand or sit upright. Some patients even develop dementia.
The disease is not widespread, with less than one-half of one percent of the general population being affected. It is more common in older people. About three percent of individuals over age 65 and ten percent of individuals over the age of 80 have the disease. There seems to be a genetic trail to the disease, since about 15 to 20 percent of Parkinson's patients have a family member who also has the disease.
Parkinson's Disease: Insomnia Causes
A 2002 survey by two Parkinson's researchers determined that as many as 42 percent of Parkinson's patients have sleep disorders. This is almost four times as many people as compared to people without Parkinson's. When the Parkinson's patients were surveyed:
- 32 percent had insomnia (as compared to only 5 percent of people without Parkinson's)
- 32 percent had nightmares (as compared to only 5 percent of people without Parkinson's)
- 15 percent had excessive daytime sleepiness (as compared to only 6 percent of people without Parkinson's)
For patients with Parkinson's disease, insomnia is usually due to one of three factors:
- The symptoms of the disease
- The medications used to treat the disease
- The age of the patient
Parkinson's patients have a loss of serotonin which affects the cells in the brainstem. They may also find that the tremors or breathing problems associated with the disease make it difficult to get to sleep or stay asleep. Some patients find that the disease keeps them from moving in their sleep, so they are prone to have pain where their body pressures against the bed.Any of these disease symptoms can cause a variety of insomnia problems such as:
- Difficulty falling asleep - Anxiety, depression, restless leg syndrome and breathing problems can keep the patient awake.
- Trouble staying asleep - The person might wake up during the night or very early in the morning and not be able to get back to sleep.
- A feeling of not getting enough sleep - They may feel like they didn't sleep long enough or that they didn't sleep soundly.
- Being sleepy during the day - The patient might find that they want to take a nap during the daytime.
Drug Side Effects
The amount of medication being received for the Parkinson's can be a big cause of insomnia. When a patient first starts on the medication or if too much medication is given, they may find it hard to fall asleep. Once they fall asleep, they might have vivid dreams, nightmares, sleep terrors or other sleep disorders. If the dose is too small, the patient can have problems staying asleep because they are not able to get comfortable or roll over in bed.
Since the Parkinson's patient tends to be over age sixty, they may also suffer from many of the sleep disorders which are common for older people:
- Want to sleep fewer hours
- Wake up during the night
- Trouble getting back to sleep
- Reduced levels of melatonin
A person with Parkinson's might be sedated during the day to lessen the tremors. This sedation can results in daytime sleepiness and frequent naps which, in turn, make it more difficult to fall asleep or stay asleep at night.
For More Information
There are several books which have additional information on the relationship between Parkinson's and insomnia:
- Handbook of Sleep Disorders - Michael J. Thorpy
- Life in the Balance: A Physician's Memoir of Life, Love, and Loss with Parkinson's Disease and Dementia - Thomas Graboys
- Living with Parkinson's Disease - Kathleen E. Biziere
- Parkinson's Disease: A Complete Guide for Patients and Families - William J. Weiner, Lisa M. Shulman and Anthony E. Lang