Parkinson’s symptoms and sleep

Problems with sleep are common in Parkinson’s. They can happen at any stage of the condition.

Trouble getting to or staying asleep can be caused by a symptom of Parkinson’s or a side effect of your Parkinson’s medication.

Parkinson’s symptoms, or side effects of Parkinson’s drugs, which might make it difficult to sleep include:

• stiffness (rigidity). Stiff muscles might make it difficult to turn over in bed. Satin sheets or pyjamas may help, but don’t use both at the same time, this could make you slide out of bed too quickly.
• uncontrolled muscle movements (dystonia). Uncomfortable muscle spasms can happen as your levodopa wears off, which could disrupt your sleep. If this happens to you, speak to your specialist or Parkinson’s nurse, as your medication may need to be adjusted.
• restless legs syndrome. Symptoms, including a powerful desire to move your legs, generally get worse in the evening or at night. Your GP may recommend medication or changes to your diet. Stretching, massaging your legs and getting exercise during the day can help.
• anxiety or depression. How we feel can disrupt our sleep, and depression can cause people to sleep too much. Talking to others, including professional counsellors, can help.
• low blood pressure as you get out of bed (postural hypotension). Getting up slowly and sitting up in bed before you stand may help you avoid dizziness. Take care and move carefully, especially if your bedroom is dark.
• "wearing off" periods. If your Parkinson’s drugs wear off during the night, stiffness, tremor or pain may interrupt your sleep. Your specialist may recommend switching to medication that’s delivered to your body continuously.
• pain from lack of movement (akinetic pain). This could keep you up at night.

Easing any of these symptoms can help improve your sleep. A new medication, or something you can do yourself, might help.

Speak to your specialist or Parkinson’s nurse for advice. They may refer you to other healthcare professionals like a physiotherapist or an occupational therapist. 

Parkinson’s medication

Some Parkinson’s medication can cause sleep-related side effects, including:

• feeling tired (somnolence). Examples include some dopamine agonists, like apomorphine or rotigotine patches (Neupro) and foslevodopa with foscarbidopa (Produodopa).
• falling asleep. Some Parkinson’s drugs, like apomorphine, can cause you to fall asleep after a dose. This isn’t common for apomorphine though.
• feeling more awake. Amantadine is a dopamine agonist which can help with involuntary movements (dyskinesia) and muscle stiffness, if other Parkinson’s medication has not worked. Some people find it can make them feel more awake. This stimulant effect can be helpful if it makes them feel more alert during the day. However, it can also cause sleep problems as a side effect.

If you think your Parkinson’s drugs are causing sleep or night-time problems, speak to your specialist or Parkinson’s nurse. They will review your medication, including any drugs you’ve started taking recently or taking at a higher dose. This will help them work out what could be causing your sleep problems. 

See our information on drug treatments for Parkinson’s.