How can we keep my father, who suffers with Parkinson's, awake during the day?
My father has Parkinson's and sleeps all day long. He gets up for meals and meds and goes back to sleep. What can we do to keep him awake? He complains he's always tired.
I'm sorry to hear that father is only awake for what sounds like a few hours a day. I agree with many of the other answers, as sleep disorders are part and parcel of PD. That being said, there are a number of step that we take to try and help:
1) Many PD medications can actually cause sleepiness and we try to minimize the use of these. Specific "bad actors" in this regard include the dopamine agonists (mirapex and requip), Artane and sometimes even sinemet, although to a lesser degree usually.
2) Make sure that other medications aren't playing a role. A number of chronic pain meds can make people very sleepy, as can medications like ativan, valium or clonazepam.
3) We try to adjust patient's sleep cycle such that they sleep more at night and less in the day. We do this with a combination of "environmental modification" and medications depending on the patient. For example, we get the family to try and keep their PD patient up for almost all of the day if possible as well as try to make them get lots of sunlight and exercise (to whatever degree possible) during the day. Then at night we sometimes will use medications to make sure that they don't stay up most of the night and then sleep most of the day. The medication that we use depends a lot on the patient, whether they have dementia or not, etc.
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4) Sometimes, depending on the situation, we can try to use medications like provigil or nuvigil to help patients be more alert during the daytime.
Indeed this is a very difficult problem and there are not easy solutions, but hopefully this provides a little guidance.
My father suffers from PD and recently was hospitalized for TIA. After bp was stabilized and tests were complete, he was still lethargic and his daytime sleepiness was more obvious as we were hovering. Drs did not want to release him in that condition and administered a double IV bolus. B4 they were finished he was lively, much like the man he was 10 years ago. When asked how we could duplicate that response, the drs said to keep him super hydrated, especially with water. Diminished appetite often accompanies diminished thirst in the elderly and you have to gently remind them to drink lots of water. They suggested keeping his pitcher or jug of water in the middle of the table so he could see how much he had consumed. We still have to remind him almost hourly to drink more. It does have an effect but not like the bolus!
This seems to be a pretty common situation with PD. My Dad has the same situation and I try to have some daily activities built into the schedule and try to keep the same routine from day to day. Reading the daily news at the same time, exercising at the same time, having a snack with needed liquids to break up a nap, watching a favorite TV show or movie, phone calls to friends/family, etc.. I try to keep the daily sleeping at a minimum to allow for better sleep at night. One hour maximum unless he's had a bad night the night before. I try to only have about a 30 min. nap in the morning and afternoon and include other things to keep him busy and not resorting to sleeping too much. Once this became a routine it has really helped with the oversleeping during the day situation. He knows the routine and does much of it independently. There are days that revert back to the old problem - but for the most part things are better with a routine of daily activities to look forward to and participate in.
I had a Stroke and Brain Surgery more than 5 yrs. ago. For being a Registered Nurse for 40 yrs. I work and read constantly, anything that pertains to PD . My family is surprise that I lasted this long. because I am scared to lost my memory, I constantly read.Currently,my right side of my body felt like a burning sensation continuosly, but i tried my best to walk with a walker around the house. I don't want to sleep continuously, so I won't get to be bedridden.
My husband has PD. It's a sleep disorder too. My suggestion is to let your father sleep whenever he wants to. My husband will go through bouts of insomnia from time to time. Just let your dad do what he needs to do with his sleep. It's such a blessing when he gets restful sleep.
My 88 yr old Dad has a form of parkinsons and some dementia. During a 4 month period last year he moved several times between hospital and nursing home rehabilitation for various incidents. It was then that his mental state declined rapidly and he began to suffer from insomnia. He has been home now for 9 months and still has horrible sleep patterns. He wants to sleep most of the day, is restless and cranky then is up and down all night long - sometimes every 10 minutes! We try to get him to participate in activities to no avail.
I take him to an adult day care program 3 days a week where he gets fresh air just from getting out of the house to the car to DayBreak and he has lots of stimulation at the program. He rarely naps there. On those days he is like a different person - much more pleasant, energetic and clearer thinking.
Also you may want to talk to your doctor about medications you loved one is taking. I recently started giving Dad his last dosage of Sinemet later at night (10-11pm). His shuffling was getting worse so I thought a later dosage would keep the drug in his system longer to help his walking in the morning. As an added bonus, he started sleeping so much better at night!! I believe it is because he has fewer leg cramps and stiffness.
But even with a good nights sleep, he is still very tired and groggy the days when he is at home sleeping most of the day. If I could only find a way to keep him awake and active at home, life would be good.
My wife was diagnosed with A-typical Parkinsonism at 57 ( three years ago). She went through bouts of sleeping all day, being very detached and unaware and being unable to engage in conversations with those around her. Her doctor prescribed the drug Provigil, which is a drig developed to treat sleep disorders like narcolepsy.
The drug has worked wonders for Bev and greatly improved her quality of life. I will warn you that the drug is very expensive; 30 pills run over $450. Because the drug is not specifically labled to treat Parkinsons's patients, I had to fight with my insurance company (formal appeal process)to get them to cover the Rx.
My husband has Parkinson's disease and was having difficulty sleeping. We were referred to a sleep specialist who ordered a sleep study. It was determined that he had sleep apnea and he has been using a CPAP machine for 4 months. It took effort to find a mask that fit and the right skin protection for his nose but he is now able to sleep for 4 to 5 hours at a stretch. I wish his doctors could work together as a team. However, I try to keep them informed. We are fortunate to have a University Medical Center with outstanding physicians who are able to share electronic records--that helps.
dx 40 / now 57. For me the day is filled with so many distractions and I divert too quickly. It is so hard to stay on task. There is peace at night, so I can get things done. The compromise I made was lights out at 1 am then sleep in until a wake on my own. This will change for different situations and time. Bottom line: Day time tasks are ones that require others to assist or simply enjoy their company. Night time is for flying solo and peace. String these together with a solid, but not necessarily too rigid, routine makes a body feel good because it knows what is expected. It is also easier to balance drugs.
please tell me more about the double IV B4 bolus.
I am a carer for my husband who has been diagnosed with PD for 5 years. He wears a mask for sleep apnoea.at night which gives him quality sleep. He wears a uuridome (external catheter) which means he doesn't need to struggle to get to the toilet all the time. He goes to exercise class and to day programs which keep him busy most days. He sleeps most of the one day he is at home all day, but I figure that's not bad as he is active the rest of the time. As his carer I do get exhausted keeping him busy but he has quality of life.
I don't know if this will help, but I read before that vitamin D3 helps PD patients. My husband really gets no sun. I'm going to start him and myself on it tomorrow. Supposedly, it helps for tiredness, muscle strength and bones. Since falling is a major concern in this household, it can't hurt. Getting the real thing would be great, but we're always burning off pre-skin cancers.