Windsor Parkinson Meeting September 27, 2011

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Parkinson Society Southwestern Ontario.png . . Super Walk for Parkinsons 2011 Logo.jpg

Parkinson home.jpg . . Welcomes Guest Speaker : Karen Riley Parkinson's Education Program (PEP)

Karen Riley, will be presenting "Sleep and Fatigue for Parkinson's patients."

Karen Riley

Parkinson's Education Program
Hotel - Dieu Grace Hospital

Tracey Jones

Manager, Programs and Services
Parkinson Society Southwestern Ontario
4500 Blakie Road,Unit 117, London, Ontaio N6L 1G5

Fax 519-652-9267 1-888-851-7376

Daily Pill Time Reminder

Curtesy of
Contact Tracey Jones
4500 Blakie Road,Unit 117, London, Ontaio N6L 1G5

Fax 519-652-9267 1-888-851-7376
$18.00 subject to change - Contact Tracey Jones
A page from "Parkinson Education Program for Community Caregivers (PEP)
Karen Riley Presentation Parkinson's Education Program

. . • Objectives

  • Sleep disturbances
  • Managing sleep disturbances
  • Fatigue
  • Energy conservation

. . .
. . .
. . .

. . .
. . • Sleep Disturbances

  • Majority have trouble sleeping at night
    • -Due to Increased symptons
    • -Side effects of medications
  • Causes of sleep disturbances
    • -Parkinson's disease
    • -Its treatment
  • Not known which is more to blame

. . .

Types of Sleep Disorders • Insomnia
  • Mostcomman type of sleep disturbance
  • Difficulty falling asleep and staying asleep
  • Frequent awakenings
• Hypersomnia
  • Feelings of extreme fatigue and sleepiness
  • Excessive drowsiness during the day
• REM sleep disorders
  • Acting out dreams
  • May be along with large body movements and / or screaming
  • may infict injury to bed partner
• Sleep apnea
  • Periodic momentary interruption of breathing during sleep
  • Duration 10 to 60 seconds
  • Frequency up to 30 times per night
• Night muscle cramping ( Dystonia )
  • Painful involuntary movements in the form of muscle contractions or spasms often affecting the legs and feet
  • Commonly occurs in the early morning when dopamine levels are low
• Nightmares
  • Disturbing dreams
  • Periods of unconscious agitation and activity
  • Often a side effect of medication
*Restless leg syndrome
  • Uncomfortable sensations in the legs that are relieved by movements
  • Sensations are usually worse at night and can disrupt sleep
  • Waking up with the urge to urinate several times during the night
*Matching Activity Game
  • What type of sleep disorder do

you have?

Managing Sleep Disturbances* *Contact physician if:
  • Too little medication in evening can cause bed immobility, cramping and stiffness
  • Too much medication can be a factor in causing bad dreans, muscle jerk, sleep

walking and hallucinations

  • Medication side effects such as insomnia or excessive sleepiness are also possible
REMS Sleep Behaviour Disorder*
  • If you are suffering from sleep disorders such as REM Sleep Behaviour Disorder or

Restless Leg syndrome or sleep apnea, this should be reported to a sleep specialist or the prescribing physician for specialist or the prescribing physician for treatment options

Painful muscle contractions*
  • If you are suffering from painful muscle contractions (similar to cramps or spasms) in the

early morning, contact doctor about the possibility of using dopamine agonist or slow release preparation of levodopa that can be taken the night before

  • Several cases may respond to botulinum toxin

injections to weaken and relax the overactive muscles

*Daily routine
  • Establish a daily routine to go to bed and wake up at the same time each day
*Physical activity/stimulati ng activity
  • Engage in exercise during the daytime

hours and avoid in the evening especially within 2 hours of sleeping

  • Drink caffeinated drinK or food (eg coffee, tea, soft drink and chocolate (in

the morning rather in the afternoon or evening

  • If you visit the bathroon several times a

night, consider installing a bedside urinal, commode or bedpan to avoid the hassle of travelling to the toilet

  • Fluid intake in the even$rry should be

avoided if frequent trips b the bathroom are an issue

  • Eat a light snack before going to bed to avoid hunger in the middle of the night
  • Consider installing a nightlight in the

bedroom to make it easier and safer to get to the bathroom at night and to help reduce visual hallucinations that are triggered by a dark environment

*Hard time moving around in bed?*
  • The mattress should be firm and at the proper height
  • A satin fitted sheet OR silky pajamas (not both)

can make it easier to move around in bed

  • A satin fitted sheet OR silky pajamas (not both)

can make it easier to move around in bed

  • A visible pathway from the bed to the bathroom at night
*Minimize distractions or triggers
  • These could be causing a disruption in


  • Eg- excessive noise, hunger, bedroom

temperature, uncomfortable mattress

*Bedroom temperature
  • Adjust this to suit the needs of the person
*Relaxing daily evening routine
  • Play smooth music while lying down or

sitting in a comfortable chair

*Expose yourself to daylight
  • Daylight stimulates your body to stay

awake during the day so that you are more tired at night

*Reduce daytime naps
  • Daytime naps can cause sleep disruptions

at night

  • Reduce the # and duration of daytime

naps if you feel very tired during the day and need to sleep

*Sleep Disturbances
  • Helpful Hints Game
  • Common symptom of Parkinsons that is

present in all stages of the disorder

*Contributing Factors
  • Loss of dopamine in the brain
  • Resting tremor
  • Muscle rigidity
  • Slowness of movement
  • Lack of sleep
  • Depression
*Energy Conservation TiPs
  • Can be used to help reduce fatigue
  • What ways do you save your energy?
  • Doing too much in one day can lead to


  • Balance physical activity and activities of daily


  • Simplify tasks
  • Can you sit instead of stand?
  • Sitting conserves energy and reduces the risk

of falling

  • Avoid battling uselessly against periods of


  • Postpone task to another time when

medications are controlling the symptoms more effectively or move onto a task that requires less energy

  • Get rest without reaching exhaustion
  • Rest could be just lying on the bed vs


  • Use assistive devices when necessary
  • Occupational therapist can help you find the

appropriate device

*Sleep and Fatigue
  • Most patients with Parkinson's disease

have trouble falling asleep at night symptoms and side effects of medications

  • Fatigue is a common symptom of

Parkinson's that is present in all stages. Energy conseuation tips can be useful

*What are your suggestions
  • What has worked for you in the past?
  • How do you manage sleep problems?
  • How do you conserue your energy?

You may direct your questions and comments about his page to Rick's Clicks
Use Rick's online contact form HERE.

Windsor Parkinson’s Support Group

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