How do you keep a person with fairly advanced Parkinson's disease from falling asleep?

[Sylphide]

Should you try to stop a person with moderately advanced Parkinson's disease from sleeping? I have been doing so up till now but it is getting very difficult. As soon as there is no food on the table or things to do he falls asleep. Too much sleep in the daytime means less or lighter sleep at night.

[reedboat2]

Need a healthy routine: daily exercise, afternoon nap, early bed time

[Sylphide in reply to reedboat2]

Thanks, Reedboat2. Those are useful suggestions. I have not routinely encouraged him to take an afternoon nap. I had read some argument against naps but I think he needs a sleep somewhere in the middle of the day. Daily exercise is hard to keep to but we are getting there. I have not gone for early bedtime. That would be interesting to try. I was afraid he would wake early in the morning. He tends to want to get dressed well before getting up time anyway and I have to discourage him. The dementia has a stronger hold over him at night....

[Hikoi in reply to Sylphide]

Was the advice re not having naps specific to pd? I ask because many pwp need a daytime rest. I try and stay awake but often don't succeed. I don't find i sleep any better at night if I stay awake all day.

Levadopa makes me tired too.

Contrary to LAJ I need dark glasses when in the sun. Since having pd I find my eyes do not tolerate bright sunlight.

[Bazillion in reply to Sylphide]

Sleep hygiene is VERY important.

Coping with Parkinson’s disease isn’t easy and will depend on the type and severity of the symptoms. However, there are certain things you can do to minimize symptoms, including taking medication as prescribed and getting healthy sleep. Here are some sleep tips for Parkinson’s patients:

Keep a regular sleep schedule, going to bed and getting up at the same time each day.

Take sedating medication late enough in the day so that you don’t get an increase in symptoms as you are trying to sleep.

Use satin sheets and pajamas to help with getting in and out of bed.

Minimize beverages before bedtime to help avoid nocturia (frequent nighttime urination).

Get exercise and exposure to light early in the day.

If the Parkinson’s disease is not advanced then behavioral therapies may be useful to try. Behavioral techniques may include changing attitudes about sleep, learning new sleep habits, and sticking to a regular sleep schedule.

Parkinson’s patients are encouraged to spend time outdoors and to exercise each day, preferably in the morning or shortly after waking. Light therapy may also help normalize the sleep/wake cycles of Parkinson’s patients, especially those who may be unable to spend time outdoors.

In general, the quality of life for patients with Parkinson’s disease may be optimized with support and recognizing the opportunities to make lifestyle adjustments. That is why support groups for patients, family members and caregivers can be important. They introduce the participants to caring and supportive individuals and you can learn what decisions others have made and what works best. This can help avoid getting "stuck" at one stage and can help to take advantage of a useful idea. Support groups may be in your local community or you may be able to participate in information exchanges online. Visit the National Parkinson Foundation support group information page to find support resources in your area.

Reviewed by David Rye, MD, PhD, and Mark Mahowald, MD.

[LAJ12345]

Bright light outside early in the day eg on a walk is good. Make sure he is not wearing tinted glasses though as it blocks the light. What medication is he on? Does any of it have sleepiness as a side effect. Mirtazapine made my husband very dozy and he is doing much better on a much reduced dose.