My husband DX'd in 2017, had been taking 10 mg of melatonin, mainly to help with startling outbursts while sleeping (mostly yelling, strong jerking motions). He hit me on the head once thinking he was playing volleyball. It got so bad, we bought a king sized bed and I started putting a long body pillow between us for protection. He had started melatonin at 3 mg, increasing finally to 10 mg. I was concerned he was needing more and more, so I researched other options, and read about L-Tryptophan, an essential amino acid found in protein foods, like turkey. I started him on one capsule of 500 mg 30-60 minutes before bed, and the first night, no outbursts. It has been 2 weeks now and so far, that issue is gone. He still wakes up on occasion, but no more yelling and thrashing. He says he sleeps better. I am also a lifelong insomniac, and it has helped me fall asleep, and although I still wake up at night, my sleep quality in general, is better. If you have similar issues, it might be worth a shot. I purchased the Vitacost brand on their website and it is relatively inexpensive. Just make sure you don't take it too close to your last dose of PD meds, since as I mentioned, it is an amino acid found in protein, which we all know by now, protein has been known to interfere with medication absorption. Please do your research first on L-Tryptophan as there may be other meds with which this supplement is not compatible.
L-Tryptophan supplements to aid sleep issues - Cure Parkinson's
L-Tryptophan supplements to aid sleep issues
Thanks so much for sharing this! I struggle with the same issue and it’s really difficult for my partner as he has insomnia and I wake him every night with my antics. I hope I have the same success!
Please reply back after you've tried it. I am curious if this is helpful to others, as well... 😴
Thanks for sharing. I will try it as my husband also thrashes around in bed. I sleep with body pillow between us after getting hit twice as he is always fighting off some attacker in his dreams. He is already taking 20 mg of melatonin so I will add the L-tryptophan .
Same here. My husband had regular dreams of fighting off an attacker... broke my heart, as if fighting Parkinson's during the day wasn't bad enough. I wonder, though, if you should just try the tryptophan alone to see if that works, not in addition to the 20mg of melatonin? That's why I wanted him to get off of melatonin. He seemed to need more of it without any better sleep quality. Just a thought. Wishing you the best!
I like my acting out It makes for funny stories !
I’ve actually always been an active sleeper ... just enhanced now !!!!!
Tell me I didn’t just say something positive about PD?!!!!
Be well all
C!
Nothing against tryptophan but you should read Chartists research on melatonin on this site.
Thank you... I haven't read Chartist's research on melatonin, but always open to learning more. Melatonin was just not effective for my husband after a time. So far, the Tryptophan is working for both of us with better sleep quality. I am grateful for anything that helps with his nightly outbursts. They were becoming scary and unbearable.
I was taking 10 mg of melatonin every night but it was causing a lot grogginess in the morning even after taking it for months. I switched to 500 mg of L_tryptophan 1 hour before bed and now I sleep much better with no morning after affects.
"which we all know by now, protein has been known to interfere with medication absorption. "
it all depends on a # of factors.
L-tryptophan in a singular amino acid and precursor to serotonin (which is beneficial with PwP) . it does cross the BBB.
read Sandyk and Fisher (1989). they highlight the role of serotonergic deficiency in the pathophysiology of Parkinson's disease and of levodopa-induced motor fluctuations, and suggest that L-tryptophan supplementation may be useful in ameliorating motor complications of chronic levodopa therapy in the disease.
Sharon
Tryptophan is actually a precursor for serotonin which is the precursor for melatonin and at that dose, you may be getting more melatonin than the 10 mg he was taking. Although many people feel that 10 mg of melatonin is a lot because melatonin is mainly thought of as a very low dose sleep aid, 10 mg is actually a low dose compared to what is used in human studies that reach into the 100 to 250 mg range on up to 1,000 mg range. The 10 mg melatonin/ PwP study showed benefit in non motor symptoms while the 50 mg PwP study barely started to show motor symptom benefit during off time. Both studies used a dose that is likely too low to illustrate the maximum benefit that melatonin may offer PwP. Here are 2 posts that discuss the role and potential of melatonin in PwP:
healthunlocked.com/cure-par...
healthunlocked.com/cure-par...
Another important consideration is that melatonin has very poor bioavailability with high end estimates of just 15% and low end estimates as low as 3%. That means that your 10 mg dose may actually only equate to 1/3rd of a milligram absorbed.
It sounds like your husband has REM Sleep Behavior Disorder (RBD) which is common in PwP. The standard medication for this disorder is Clonazepam (Klonipin), but melatonin is thought to be as effective as Clonazepam for RBD.
mayoclinic.org/diseases-con....
Studies suggest that RBD with PD can increase the risk for dementia.
researchgate.net/publicatio...
On the other hand, melatonin has shown itself to be beneficial for RBD, PD as well as dementia.
ncbi.nlm.nih.gov/pmc/articl...
pubmed.ncbi.nlm.nih.gov/324...
frontiersin.org/articles/10...
All of the above does not go into the multitude of benefits that melatonin offers the PwP brain such as protection of the mitochondria and dopaminergic neurons, reduced inflammation, reduced oxidative stress and repair of the perturbed blood brain barrier and reduced Alpha Synuclein production and aggregation. Melatonin also boosts the bodies own antioxidant system and increases the total antioxidant capacity to name only a few. These are all benefits that the current PD medications can not do.
Art
Art, For RBD my husband takes 5-HTP and melatonin, and CBD oil. I believe he is sleeping better, but he still has out bursts and lots of movement. When I looked up L-Tryptophan it is similar to 5-HTP (5-hydroxytryptophan). When he started having RBD, I knew it was something new after 35 years of marriage , but couldn't figure it out until I heard Alan Alda and J Fox having the same as first symptom of PD. Listening to videos on sleep and PD this was the first thing I have tried to conquer in hope of slowing down progression. But I am confused now about the similarities or differences of 5-HTP and L-Tryptophan. Can you explain? I am thinking of replacing the 5-HTP and going with 500 mg of L-Tryptophan instead. Since he still isn't totally experiencing sound sleep. But I will keep the melatonin. Thank you for your help.
Ghmac,
5 HTP and Tryptophan are both precursors of serotonin and consequently melatonin, but 5 HTP crosses the blood brain barrier at an increased rate compared to Tryptophan, which will likely mean a faster onset of action. 5 HTP is also more efficient at the conversion to serotonin compared to Tryptophan. Melatonin is where I have been concentrating my efforts because the studies re melatonin and PD are clear. I do not look at melatonin so much as a sleep aid because in my experience the results are hit and miss, but I do think it will ultimately turn out to be more useful for PD in the long run as studies continue to expand. The known protective effects of high dose melatonin animal studies on many PD related issues is important because they are suggesting very good potential at reducing symptoms and possibly reducing disease progression, but the needed high dose studies in PwP are still lacking. The 10 mg and 50 mg studies in PwP are all that I am aware of.
There are many other reasons why I consider melatonin very important because it is protective of all major organs, is the most potent antioxidant produced in the body, can help prevent stroke while also being useful as a stroke treatment as I have written about here because PwP are more likely to have a stroke than non PwP :
healthunlocked.com/cure-par...
PwP are also at elevated risk for cardiovascular disease (CVD) and melatonin can act as a preventative or treatment in this area also :
healthunlocked.com/cure-par...
Melatonin has shown itself to be quite effective at treating Covid-19 and may actually have preventative effects as I have written about here:
healthunlocked.com/cure-par...
Osteoporosis is also more prevalent in PwPs and melatonin can help in this area as I wrote about here :
healthunlocked.com/cure-par...
These are some of the reasons why I have been taking at least 106 mg of melatonin a day since last year.
Art
...When I looked up L-Tryptophan it is similar to 5-HTP (5-hydroxytryptophan).
Just to correct the record, they are quite different: ‘approximately 95% of tryptophan is involved in the kynurenine pathway, while the remaining tryptophan (5%) is used for the synthesis of serotonin and melatonin.’ - Simon/Science of Parkinson’s
scienceofparkinsons.com/202...
So if you are interested in maximizing Serotonin and Melatonin production 5HTP is the way to go.
Nonetheless, L-Tryptophan does have some unique benefits as discussed in the link provided. 🌺
Thank You Chartist and caseyinsights, you both have been very helpful. I think we will stick with the melatonin but up the dosage, he is only getting 3 m of liquid a night.
I can't tell you both how much I appreciate your help, explanations, resources and contributions. I would be so very lost with out the forum and without people like you two. I have learned so much on this site, and from I can tell this collective knowledge is way passed and beyond the only neurologist we have spoken to.
Hi Art,
I appreciate your thorough input on melatonin. It does appear that melatonin has it's benefits for the PD brain, but speaking as it relates to my husband's sleep disturbances, it didn't seem to be helping, and we are getting great results from the tryptophan without having to go the Clonazepam route. However, it sounds like he would benefit from continuing the melatonin, in addition to the tryptophan, so perhaps, I will have him continue with the 10 mg. Thank you so much for the information; I continue to learn much from the generosity of members' input to the forum.
Gwen
Anyone thoughts about L-theanine? Does it have the protections mentioned above? (protection of the mitochondria and dopaminergic neurons, reduced inflammation, reduced oxidative stress and repair of the perturbed blood brain barrier and reduced Alpha Synuclein production and aggregation)
Hi there, yes I tried L-Tryptophan to improve my sleep with limited improvement. Also tried Melatonin up to 10mg 60mins before going to bed, nothing much to report. Then I was told to take melatonin at sun down - Bingo - That did the trick.
As long as you stay relatively quiet for the next few hours, by the time 9 or 10pm comes I become so sleepy that I can hardly get up to my bed. Often, I am asleep in less then 60secs. I take 6mg per evening and it’s more than enough. Give it a try .....
I’ve recently discovered that a few puffs of a joint before bed enables me to sleep the whole night through, rather than waking at 3am and staying awake for hours.Unfortunately it is illegal here and I hate inhaling, but if you live in a more enlightened place it may be worth exploring as you can get oils and edibles etc.
IMO solving vitamin b3 NA deficiency will solve the sleep problem. Because it would seem that the Pwps are for some reason very lacking with all the consequences. Here is an article by Simon to start research on the subject.
scienceofparkinsons.com/201...
scienceofparkinsons.com/201...
" The liver can also use tryptophan to produce niacin (vitamin B3), which is needed for energy metabolism and DNA production. "
Sounds perfect!
How is the Tryptophan working? Still controlling the sleep outbursts?