Importance of sleep in dealing with both motor & non-motor symptoms: By Dr. De Leon

“The future is shaped by our dreams so what are you waiting for and go to bed… START DREAMING!”

We have known for years that sleep is essential for our brains to function adequately. We  also know that people with Parkinson’s have a very disruptive sleep wake cycle for many reasons, the primary being a disruption in sleep wake cycle which is mediated by serotonin. Many of you like me sleep only a few hours every  48-72 hours.  This way of living is not only detrimental to our physical, emotional, and mental health; but actually as I have recently concluded, poor sleep architecture is one of the main if NOT the MAIN reason why we as individulas with chronic illness like PD feel so poorly. Perhaps even contributing to our eventual demise.

First, sleep is a way for our brains to encoding information into long term storage as well as discard the waste accumulated. This process needs to be done routinely otherwise trash accumulates and eventually can take over impeding the brains normal flow. this is a kin to not washing dishes day after day letting them accumulate in the sink and kitchen area, pretty soon you will run out of storage space, deal with toxic odors, over growing mold/bacteria, impede the flow of your cooking area and have no dishes left to cook or eat with. the constant tidying up keeps things not only neat but flowing and functioning at maximum capacity, likewise our brains.

Second, during sleep we strengthen/ boost our body’s immune system. This is important information considering new theory of PD that disease begins with the gut possibly by over wrought harmful bacteria which then makes its  way to the brain. weakened immune system  from poor sleep could also explain why people with PD are more suseptible to even minor infections like the common cold. I should know, I had about 6 months of down time due to upper respiratory infections.

I certainly, have become much more sickly since diagnosed with PD.

Third, sleep problems especially chronic insomnia can lead to changes in mood such as depression along with increased anxiety as well as decreased coping mechanisms for dealing with stress leading to increase irritability.

Fourth, sleep deprivation also causes widespread pain in joints and muscles by increasing inflammation. the constant pain imposed on our sensory system causes a centralization of pain making our brains much more sensitive to even the slightest discomfort. After all the brain cannot distinguish between physical and emotional pain. interesting thing, I can always tell my body not had enough sleep/ rest if my joints hurt, have swelling in hands, and stiffness of joints and muscles. I can almost feel the inflammation and pain of dystonia melting away as I sleep – the throbbing, aching pain in my arm which occurs with repeated use slowly vanishes with sleep.

Intuitively, I suppose that by ensuring best sleep practices via various medications and life style changes my patients overall did not seem to progress or have as many non -motor symptoms. the funny part was that I had been suffering like many of you with sleep deprivation which always made all my other symptoms worse ’til it dawn on me; why am I not taking sleep aids I used to prescribe for my patients?

I began taking one of my most commonly prescribed medications for sleep – in my case Lunesta and voila not only did I sleep well without being groggy the next day but having a constant refreshing sleep has allowed me to improve my quality of life dramatically. Once again, I feel energized both mentally and physically.

I think that we need to focus more on trying to regulate our sleep by whatever means possible in order to improve our quality of life and protect our brains from slow deterioration.

Sleep meds I often used in my patients which worked well and caused little to no daytime sedation nor interfered with other PD meds or symptoms.

• Lunesta : (I like because it has multiple dosages 1mg, 2mg, and 3mg- plus does not typically cause sleep walking or other such bizarre behaviors like Ambien. Plus it does not build tolerance quickly safe to use on a daily basis).
• Sonata: also very mild- much milder than Lunesta so I preferred to use in elderly patients.
• Restoril
• halcion
• remeron ( which has added benefit of helping with tremors)
• doxepin
• elavil ( not goo din elderly because can worsen low blood pressure and memory loss, on the other hand it can help depression if present while aiding sleep)
• melatonin ( otc)
• klonopin ( great for tremors and dystonia but can cause short term memory loss if take chronically)

if you are still struggling with sleep issues talk to your physician today.

Pleasanr dreams everyone!

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all rights reserved by Maria De Leon MD