In order to get a good night’s sleep, we need to spend a certain amount of time in REM sleep (Rapid Eye Movement). This is the time that our brains go into deep sleep mode and that we loosen our muscles, allowing our brains to dream, often vividly. We all need a good amount of REM sleep each night to feel refreshed and well-rested when we wake up. But not all of us have that luxury.
REM Sleep and Parkinson’s
With Parkinson’s, REM sleep could be interrupted by the disease itself. The lack of dopamine in our brains, anxiety or depression, or other neurological dysfunctions could cause us to enter a state of REM sleep in which we actually act out our dreams. We punch, kick, yell, walk around, and do other things in our sleep that can be dangerous for us and for our sleep partners. Like with every symptom of Parkinson’s, not everyone will experience this disorder, and experiencing it is not necessarily a sign of Lewy Body Dementia, a type of Parkinson’s akin to the effects of Alzheimer’s disease.
What can you do about REM Sleep Disorder?
Often, when people first experience this disorder, their inclination is to take something that will soothe the effects, like Melatonin. Recommendations from friends with Parkinson’s, or from doctors will be to “try some Melatonin” to see if that helps. From my own experience, taking up to 10mg of Melatonin did not help me, but up to 10mg of Melatonin each night may help you. This is typically enough to stop the disorder in its tracks since Melatonin acts as a tranquilizer and helps us relax into a deep sleep.
What if you need something a little stronger?
Unfortunately, not all of us react well to Melatonin. Maybe the recommended maximum dose is still not enough to take the edge off, or maybe Melatonin leaves you feeling groggy or tired during the day. Melatonin certainly does not work for everyone. If you need something stronger, talk to your doctor about prescription sleep aids. My doctor prescribed me Clonazepam, at first at the smallest dose, 0.5mg each night, and later 1mg each night. This seems to do the trick, and it could be something to consider while you are looking for solutions. Be warned, however, Clonazepam is a serious medication that has special restrictions, like avoiding alcohol. So be sure to check with your doctor and pharmacist about any potential interactions with other medications.
While REM Sleep Disorder can be scary, it doesn’t have to be. It is a well-documented disorder that occurs with many people with Parkinson’s. It can lead to injuries for you and your sleep partner, so best to alleviate the symptoms as much as possible. While Melatonin may help many with this disorder, prescription medications that act as tranquilizers may be necessary in the long run. Always be sure to speak with your doctor about all of your conditions and medications, as Clonazepam could interact with other medications and other conditions.
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Nick Pernisco is the Parkinson’s Warrior, a person with Parkinson’s who has dedicated his life to helping others with Parkinson’s. Get the Parkinson’s Warrior book here. Join the discussion on Facebook.