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Fatigue, Sleep Difficulties and Restless Legs

Although Parkinson’s is classified as a movement disorder, it can affect people in various different ways. Sometimes the non-movement symptoms can be more troublesome and can have a bigger impact on the daily life of someone living with Parkinson’s.

Some of the more common non-movement symptoms of Parkinson’s are:

Fatigue

Fatigue is a very common issue affecting people living with Parkinson’s. As with all symptoms of Parkinson’s, fatigue can affect each person differently. Some people might describe it as an overwhelming sense of tiredness. For others the feeling of fatigue might come and go, with no major effect.

The cause of fatigue in people living with Parkinson’s can be difficult to determine. Fatigue might result from:

  • The motor symptoms of Parkinson’s
  • Disrupted sleep
  • Medication side effects
  • Something completely unrelated to Parkinson’s

Managing Fatigue

If you are experiencing fatigue, the first step is to tell your GP or specialist. There may be a medical solution, such as changing medications, which might help to reduce your fatigue.

Learning to use your energy wisely can also help you to overcome feelings of fatigue. This might involve slightly modifying your daily schedule to ensure you have energy for the activities that are most important to you.

It can be useful to discuss the issue with an occupational therapist.

Sleep difficulties

A large number of people living with Parkinson’s experience sleep problems. Not everyone experiences sleep difficulties, but it can be very troublesome for those that do. Some of the sleep problems that people living with Parkinson’s might experience include:

  • Disrupted night-time sleep
  • Day-time sleepiness
  • Vivid dreams and/or nightmares, and possibility of physically acting out dreams (known as REM sleep disorder)
  • Restless legs 
  • Waking up with a sudden urge to go to the toilet (known as nocturia) 
  • Stopping breathing momentarily during sleep (known as sleep apnoea)
  • Turning over in bed

There can be numerous causes of sleep problems for people living with Parkinson’s. In some circumstances it might be caused by Parkinson’s itself. For example, some Parkinson’s symptoms such as tremors or stiffness might keep you awake. In other cases it might be a side effect of medications. Sleep problems may also be caused by a condition unrelated to Parkinson’s, such as insomnia.

Managing sleep difficulties

Do not ignore sleep problems. They can present a danger to you and others, particularly if you operate heavy machinery or drive a car.

If you are having sleep problems, you should first tell your GP and specialist. Your doctor will help you to work out the cause of your sleep difficulties. It might be possible to reduce your sleep problems by adjusting your medications. It may also be helpful to keep a sleep diary, so that you can provide your doctor with accurate information about your sleeping patterns.

If you have problems turning over in bed, you may benefit from seeing an occupational therapist and/or physiotherapist who can provide advice on making this task easier.

Useful Tips

Simple things you can do to improve your sleep are:

  • Avoid caffeine before bedtime (such as coffee, tea, cola, cocoa and chocolate)
  • Avoid drinking alcohol in the 4 to 6 hours before bedtime
  • Avoid vigorous exercise within 2 hours of bedtime
  • Remain active and exercise regularly during the daytime
  • Keep your bedroom mainly for sleeping
  • Keep your bedroom at a moderate temperature (not too hot or cold)
  • Keep a regular routine, by trying to go to bed and wake up at the same time each day
  • Reduce noise and light in the bedroom
  • Avoid using a computer or mobile phone immediately before bedtime
  • Try to calm yourself down before bedtime by doing a relaxing activity, such as reading

Please keep in mind that some of these suggestions may work for some people but not others. Everyone’s journey with Parkinson’s is unique.

Restless Legs

Restless legs syndrome is a condition that can affect anyone, but it is more common for people living with Parkinson’s. The condition results in an overwhelming urge to move your legs. Restless legs can also lead to a feeling of burning, tingling, itching or throbbing in your legs.

The feeling of restless legs normally appears at rest; for instance it commonly occurs when people are sitting or lying down. For this reason it can be a common cause of sleep disturbance  for many people.

If you have noticed any abnormal sensations or feelings in your legs, particularly when you’re resting, you should tell your specialist and GP. The doctor may choose to adjust your Parkinson’s medications or prescribe additional medications to help manage this symptom. Your doctor may also suggest an increase in the amount of iron in your diet, as restless legs syndrome is sometimes linked to low iron levels in the brain.

Useful Tips

If you are having problems with restless legs consider trying some of the suggestions below:

  • Gently massage the area
  • Gently stretch the muscles in your legs
  • Apply a hot or cold pack to the area
  • Take a warm bath in the evening
  • Avoid alcohol, caffeine and smoking
  • Avoid foods that seem to trigger restless legs
  • Practice relaxation exercises before bedtime
  • Participate in regular exercise during the daytime

Please keep in mind that some of these suggestions may work for some people but not others. Everyone’s journey with Parkinson’s is unique.

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