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Sleep disorders are a common challenge for people with Parkinson’s disease. Problems such as insomnia, frequent awakenings, involuntary movements during the night, and, in some cases, excessive daytime sleepiness, can worsen quality of life, affecting both physical and psychological well-being. Managing these symptoms is essential for maintaining optimal health, and many 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, pharmacological therapies, and the importance of maintaining a regular routine.
Main sleep disorders in Parkinson’s
Parkinson’s disease often involves a variety of sleep-related problems, which can vary in intensity and frequency. Among the most common disorders are insomnia, restless legs syndrome, REM sleep behavior disorder (RBD), and daytime sleepiness.
Insomnia mainly presents as difficulty falling asleep or nighttime awakenings, often caused by the muscle stiffness and tremors that characterize the disease.
Restless legs syndrome is characterized by an uncomfortable sensation in the legs that triggers involuntary movements, making restful sleep difficult.
Finally, REM sleep behavior disorder is a condition where 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 careful monitoring and targeted interventions.
Non-pharmacological strategies to improve sleep
Non-pharmacological strategies for addressing sleep disorders in Parkinson’s are often effective and recommended as a first approach, as they do not carry the risk of side effects. Among these, sleep hygiene plays a fundamental role: maintaining a regular routine, avoiding prolonged afternoon naps, limiting the use of electronic devices before bed, and creating a relaxing and comfortable nighttime environment are all useful practices to improve sleep quality.
Relaxing activities like 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 to change negative thoughts about sleep and replace them with positive habits.
Pharmacological therapies and medical interventions
In some cases, non-pharmacological strategies are not sufficient, and pharmacological treatments may be necessary. However, managing sleep medications in Parkinson’s patients can be complex, as some drugs may interact with antiparkinsonian medications or cause unwanted side effects.
Hypnotic drugs, for example, are used with caution due to the risk of excessive sedation. Other treatments include melatonin and clonazepam, which have proven helpful in reducing symptoms of REM sleep behavior disorder. It is always important to follow the neurologist’s guidance, who can tailor therapy 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. Physical exercise, if done during the day, helps reduce muscle stiffness and improve mood, two factors that can positively influence sleep quality.
Aerobic exercises, yoga, and physiotherapy are particularly recommended. Regarding diet, avoiding heavy meals and stimulating beverages before bedtime can reduce digestive disturbances and facilitate deeper rest. Choosing a diet rich in antioxidants and vitamins supports overall health and may 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 interventions, pharmacological treatments, and healthy lifestyle habits. Each patient is unique, and what works for one may not be effective for another; for this reason, it is essential to collaborate with a medical team that can evaluate individual needs and adjust the treatment plan. With the right support, people with Parkinson’s can improve their quality of rest, which also contributes to better daytime symptom management and an enhanced 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.
