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Fatigue and Sleep

Fatigue

Many people with Parkinson's experience excessive daytime sleepiness. They report a loss of energy and chronic fatigue, which may be disruptive to planned activities and schedules. Consider the following:

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  • People with excessive daytime sleepiness (EDS) feel fatigue during the day and then have poor quality sleep at night. Activities that make you tired may be bad for the morning, but excellent at night. Adding exercise to the routine may improve nighttime sleep quality.

  • Think about scheduling fewer activities each day. The person with Parkinson's may have low energy and therefore may not be able to do as much as he or she used to do.

  • Consider breaking up tasks, errands, or other activities into shorter time periods, allowing for rest breaks as needed.

  • Schedule brief rest periods or naps to restore your loved one's energy during the day. Be mindful that excessive daytime sleep may prevent someone from resting well at night.

  • Recognize that your schedule may need to be flexible and responsive to how the person with Parkinson's is feeling. You may need to postpone or cancel activities based on these variations.

  • Have a back-up plan in case the scheduled activity falls through.

  • Make sure travel schedules include enough time to accommodate rest periods.

  • Be aware that the person with Parkinson's may request more assistance when feeling fatigued. Offer help as needed.

  • Encourage your loved one to avoid tasks that require significant coordination or attention when fatigued to avoid accidents or falls.

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Sleep

Getting adequate rest and sleep is an important component of overall health and quality of life. Parkinson's disease creates many challenges to getting a good night's rest, both for the person with Parkinson's and the care partner. If your loved one is not sleeping, it is highly likely that your sleep pattern will be disrupted as well.

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Bed Setup

There are many considerations when designing ideal sleeping arrangements for you and the person with Parkinson's.

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  • Choose a bed that is comfortable and conducive to sleep

  • Consider twin beds or sleeping in separate rooms to ensure better rest for both you and the person with Parkinson's

  • Use a call button, alert system, or monitor to hear the person with Parkinson's when sleeping in another room

  • Use a firm mattress to make rolling and movements easy to perform. Avoid water beds or excessively soft mattresses that hinder your loved one's ability to move or role

  • The bed height needs to allow the person to get his or her feet on the floor easily. Removing bed casters can lower the bed to a more manageable height.

  • Obtain a half side rail or bed pole for the person with Parkinson's to use as a sturdy hand grip for when rolling or when trying to get into and out of bed

  • Rolling and moving in bed can often be made easier by using a piece of slippery, satin-based fabric through the middle third of the bed, so it fits under the person's shoulders and hips.

  • Avoid flannel sheets and nightwear that add friction; these make bed movement more difficult

  • Remove the top sheet; instead, use a lightweight comforter to allow the person with Parkinson's to move more easily and prevent feet from becoming tangled

  • Hospital beds can also be used to adjust more easily. They can be raised during dressing and bathing and lowered as the person tries to get up

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Getting into Bed

For demonstrations on how to help the person with Parkinson's get into and out of bed, watch the video "Rest and Sleep Part 2" in the "CareMAP: How-to Videos" playlist at www.Parkinson.org/videos.

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  • Provide cues to help the person with Parkinson's properly align his or her body when getting into bed

  • Make sure the backs of both your loved one's legs are against the bed before sitting down.

  • Help the person with Parkinson's bring his or her legs up as she lies down, trying to stay in good alignment

  • Avoid having the person attempt to crawl into bed by placing a knee up on the mattress. this makes it difficult to achieve necessary alignment.

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Getting Out of Bed​

  • When helping the person with Parkinson's out of bed, it is usually best to start on his or her back, looking up toward the ceiling.

  • Bend the knees, allowing feet to rest firmly on the mattress. If the person with Parkinson's has a lot of morning stiffness, move the knees side to side from this position to help him or her become more flexible and ready to get up.

  • Help them onto their side. Have them reach across the body to grasp the side rail or bed pole for better leverage.

  • Once on the side, help them get their feet off the bed and begin to push up on the side rail or bed pole, moving to a seated position

  • A physical therapist can instruct you on proper techniques to perform these transfers

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Sleep Environment​

  • Make sure your loved one avoids caffeine and does not discuss stressful topics or watch loud or disturbing television programs just before bedtime

  • Set the bedroom temperature at a comfortable level

  • Try to reduce interruptions and excessive noise

  • Use recorded nature sounds or white noise to achieve a more restful environment

  • Remove objects that may cause excessive shadows or be misinterpreted in a darkened room

  • Talk to the doctor if the person with Parkinson's has tremor, stiffness, or mobility changes during the night that make it uncomfortable to sleep of if they experience frequent nightmares or hallucinations

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Sources:

Parkinson's Foundation Page 56. Coping with Fatigue. Practical Pointers. Chapter 3. Page 166. Rest and Sleep. Chapter 6. Advanced Parkinson's. Caring and Coping. A Care Partner's Guide to Parkinson's Disease. "Booklet."

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