As explained in the “Sleep Problems” section, there are a lot of reasons why people with Parkinson’s can struggle to sleep. These are some useful tips which anyone, whether they have Parkinson’s or not, can try to help improve their sleep.

Do’s

• Make sure that your bed and bedroom are comfortable – not too hot, not too cold, not too noisy.
• Make sure that your mattress supports you properly. If it’s too firm, your hips and shoulders are under pressure. If it’s too soft, your body sags which is bad for your back. Generally, you should replace your mattress every 10 years to get the best support and comfort.
• Get some exercise. Don’t overdo it, but try some regular walking. The best time to exercise is in the daytime – particularly late afternoon or early evening. Later than this can disturb your sleep.
• Take some time to relax properly before going to bed. Some people find aromatherapy or relaxation helpful.
• If something is troubling you and there is nothing you can do about it right away, try writing it down before going to bed and then tell yourself to deal with it tomorrow.
• If you can’t sleep, get up and do something relaxing. Read or listen to quiet music. After a while, you should feel tired enough to go to bed again.
• Pace your activities evenly throughout the day to build in rest periods.

Don’ts

• Don’t go without sleep for a long time. Go to bed when you feel tired and stick to a routine of getting up at the same time every day, whether you still feel tired or not.
• Caffeine hangs around in your body for many hours after your last drink of tea or coffee. Stop drinking tea or coffee by mid-afternoon. If you want a hot drink in the evening, try something milky or herbal (but check there’s no caffeine in it).
• Don’t drink a lot of alcohol. It may help you fall asleep, but you will almost certainly wake up during the night.
• Don’t eat or drink a lot late at night. Try to have your supper early in the evening rather than late.
• If you’ve had a bad night, don’t sleep in the next day – it will make it harder to get off to sleep the following night.
• Don’t spent too much time on an electronic device such as a mobile phone, tablet or computer.

If you try these tips and you still can’t sleep, go and see your GP. You can talk over any problems that
may be stopping you from sleeping.

Some people with Parkinson’s experience feelings of anxiety. Anxiety may be caused by the challenges of living with a long-term progressive condition, or due to chemical changes in the brain. Some people experience heightened anxiety surrounding social activities or activities that are out of their usual environment. Additional worries are often related to fear of falling, eating and drinking in public, toilet access and negotiating less-familiar spaces.

Your occupational therapist may be able to help you find strategies manage the anxiety and practical challenges.
More information about anxiety can be found here: anxiety.

Many people with Parkinson’s describe feelings of tiredness and fatigue but it is important to recognise these two terms as different. Feelings of tiredness can be brought on by a period of activity such as shopping, cleaning or doing a crossword, but fatigue can happen at any time without any cause and can’t be improved with rest. Fatigue is an overwhelming feeling of tiredness as though the power supply has been switched off; the result is an overwhelming feeling of exhaustion. 

Fatigue is more common in people with long term health conditions, such as Parkinson’s. The exact reasons for it are not always clear, but it can be more noticeable if tremor, stiffness or rigidity put stress on your muscles, forcing them to work against each other when trying to complete every-day tasks. Movement problems can also demand greater levels of concentration and control when completing an activity leading to mental fatigue. Strong emotions like stress, fear and anger can lead to feelings of fatigue if they build up. 

Fatigue symptoms will vary daily. Try keeping a diary of your symptoms to look for a pattern. This will help you monitor the activities which make you tired, and identify times of day when a rest would be most beneficial so you can plan them into your day. An activity diary can support you planning and pacing activities which are essential, and those which are desirable. 

The feelings and effects of fatigue are experienced differently by different people so while it can be helpful to hear useful strategies from other people, if fatigue is something that you’re finding  difficult please seek advice from your occupational therapist. It’s also important to discuss how you are feeling with your medical team. Some strategies which can help are listed here:

1. Keep a fatigue diary. This might help identify the cause and will help you be more specific when talking to your healthcare professionals about it.
2. Take rests when you need them.
3. Prioritise tasks. If you feel fatigued, put off things that can wait. 
4. Organise your living and working spaces so that you are not moving around more than you need to.
5. Do some exercise. It may not sound rational, but regular exercise will build up stamina and improve circulation, strength and mood, which will help in the long term.
6. Eat healthily.
7. Accept help when it is offered. It might be useful to make a list of tasks that you find difficult so that if family members or friends ask if there is anything they can do to help, you can give them a job.
8. Talk to other people with Parkinson’s. You might find that they have similar problems and have found ways round them.
9. Do talk to your Healthcare Professionals about it.

General Strategies

These are some of the general strategies that people find helpful, it might be useful to give some of them a try.

1. For many people, it helps to have a regular routine, so that it is easier to remember what is going to be happening in the course of the day. Make sure you have regular rest times, as relaxation can help improve your concentration, memory and attention.
2. A “To Do list” with things that need to be done, or things you would like to do, might be helpful. If you tick them off when done, it gives a sense of achievement.
3. Try to focus on doing one thing at a time.
4. Keep active. Research shows that it is really important to keep both physically and mentally active. Physical activity improves circulation to the brain as well as the muscles. Any purposeful activity is useful in keeping the mind alert.
5. Have “right places” for important things like keys, purse or wallet, reading glasses and mobile phone. Some people keep all their important things together in a “Memory Basket”.
6. Reduce distractions. It is much more difficult to remember things or concentrate if the environment is noisy or busy. Think about turning the radio or TV off and making sure you are not interrupted if you are trying to concentrate.
7. Timing: It is better to try to do the most challenging things at a time when you have the most energy. For most people this is in the morning. It’s always best to avoid doing difficult tasks when you are tired, anxious or ill.
8. Stimulate your brain with social engagements, activities you enjoy and puzzles (eg sudoku, wordsearches or crosswords)