Get physical exercise appropriate to your level of functioning, which may also promote daytime wakefulness.They may help provide stimulation to prevent daytime dozing. Participate in activities outside the home.Avoid sedentary activities during the day.Remember indoor lighting may not be sufficient to promote a normal circadian rhythm.Get exposure to adequate light during the day and darkness at night.Establish good sleep hygiene, including a set bedtime and wake-up time.This is a potential cause of motor vehicle accidents and should be monitored.Ĭonsider making certain lifestyle modifications, such as: NOTE: dopamine agonist medications like pramipexole and ropinirole can cause sudden "sleep attacks" while driving. Daytime sleepiness related to PD may arise for many reasons, including getting a poor night’s sleep or the use of dopaminergic medications, especially dopamine agonists like pramipexole (Mirapex), ropinirole (Requip) and rotigotine (Neupro). Sleepiness during the day is seen in about 30 to 50% of people with PD and it is more prominent as the disease advances. You may be referred to a bladder specialist (urologist). In addition, there are several medications that can be helpful, including oxybutynin (Ditropan®), tolterodine (Detrol®), trospium (Sanctura®), tofenacin succinate (VESIcare®), darifenacin (Enablex®), mirabegron (Myrbetriq®) and phenoperidine fumarate (Toviaz®). If urinary frequency keeps you up at night, be sure your doctor rules out causes other than PD. Also, if you are unsure, check with your doctor or pharmacist to ensure alerting medications are being taken in the morning and sedating medications are being taken at night. “Screen time” - television, phones, tablets - one or two hours before bed.Ĭertain antidepressants, such as mirtazapine (Remeron) may help with sleep while others - the SSRIs - can make other sleep symptoms worse.Thoughts or discussions before bedtime about topics that cause anxiety, anger or frustration.Heavy exercise within six hours of bedtime.Heavy late-night meals (although a light snack at bedtime may be helpful).Alcohol, caffeine and other stimulants such as nicotine.If you are experiencing sleep problems, you should avoid: Place a portable commode next to the bed to minimize effort, if needed.Consider a soft, rather than bright, light to illuminate your path to the bathroom.Go to the bathroom immediately before retiring.
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