How to Deal with Sleep Problems in Parkinson’s Disease?

It is reported that 74% of Parkinson’s patients experience sleep problems. In fact, researchers think that this sign of the disease is among the most early warning signs faced by the patient. Like other symptoms, this can also have a negative impact on the quality of life.

sleep in Parkinson's

Sleep disorders are of various types, but the one which is strongly associated with Parkinson’s is the rapid eye movement (REM) sleep.

Since the eyes move rapidly in a different direction during REM sleep, it’s termed as REM sleep. Other signs of REM sleep include fast breathing, increased heart rate, and shouting. Up to 40% of people with REM sleep have the chance to subsequently develop Parkinson’s disease.

Beside REM, other sleep disorders that are linked to Parkinson’s disease include sleep apnea (breathing disruption during sleep) and restless leg syndrome.

So how to deal with these sleep problems?

Like other symptoms, this problem of the disease can be treated with medication. And there are the 3 drugs that are used for this purpose. These are the following:

1. Melatonin

This name may sound familiar to you if you are suffering from sleepiness. Melatonin is a well-known hormone of our body that was discovered in 1917. It is mainly produced in the brain, specifically in the pineal gland region. It can also be found in other regions of the body including skin, eye, gastrointestinal tract, blood, and bone marrow.

Melatonin is a well-studied drug and many clinical studies have found it very efficient for treating REM sleep in Parkinson’s disease. For example, a study published in the journal of Sleep Medicine showed that 5 mg of melatonin improved the overall sleep disturbance when used for 2 weeks. The same study also reported that melatonin concentration of up to 50 mg is well tolerated in patients.

Similar findings were also found in another study, where it was reported that melatonin could be a favorable agent, besides clonazepam, in the treatment of rapid eye movement sleep behaviour disorder.

2. Clonazepam

Clonazepam is the drug of choice for people with anxiety, panic attacks, and seizures. But clinicians think that it could also be effective for abnormal sleep behaviour in Parkinson’s disease.

It belongs to a group of drugs called benzodiazepines. The drug acts by slowing down the brain processing and helps to inhibit the behaviors occurring during REM sleep.

Clonazepam is especially recommended for those who experience visual hallucinations, a sign of Parkinson’s that according to researchers could be most likely related to REM sleep.

A study published in the Journal of Movement Disorders found clonazepam very effective in treating the visual hallucination due to REM sleep in Parkinson’s patients. In this study, when clonazepam was given to 8 hallucinators for 2 weeks, 3 of them were completely recovered while 2 showed 50% decrease in the frequency of hallucinations. The rest 3 did’t show any effect.

Similarly, a review study that summarized a world literature on RBD has reported clonazepam as an effective drug against RBD in 90% cases.

However, it does cause some side effects that may further deteriorate the patient’s condition. For example, it causes hangover or balance disturbance that increases the chances of falls and the patient may experience serious injuries. Therefore, one must consider these side effects before taking it.

3. Lorazepam

Lorazepam is the alternative to clonazepam. It also belongs to benzodiazepines class and acts similar to clonazepam. However, the effects are for short time and provides less side effects than clonazepam. Plus, it also has a lower risk of addiction.

Lorazepam is effective in alleviating sleep disturbance and daytime sleepiness in people with Parkinson’s disease. It may also help improve other symptoms like muscle cramp and rigidity.

However, one should use it with caution as its overdose can cause some serious effects. For example, it can severely affect your thinking ability and often leads to confusion. In addition, it can also disturb your balance or coordination.

Other Safety Measure:

In addition to medication, Parkinson’s patients should also follow some safety measures in order to avoid potential physical harm. These are:

  • Use the bed with padded side rails
  • Keep your bed close to the floor
  • Keep your bed away from large window or wall
  • Use separate beds for sleep

Disclaimer: The information shared here should not be taken as medical advice. The opinions presented here are not intended to treat any health conditions. For your specific medical problem, consult with your health care provider.

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