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Strrme

No Sleep For The Weary

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I am reaching out to anyone who can please help.  We are at our wits end.

My 82 year old mother was diagnosed with Parkinson's Disease about 5-6 years ago.  She's been on Sinemet the whole time with increases here and there or changing her time to take.  Mirapex was introduced probably at the beginning of 2016 because the Sinemet was not holding her over between doses.  However, at some point at one of her visits, the Neuro doctor told her to take the Sinemet and Mirpaex together, 3 x's day.  She has had so many falls, that I'm surprised that she's only broken her nose 4 times, front teeth, fractured T-12 that healed without physical therapy and she now has almost a solid 90 degree bend looking down and so many bruised and swollen knees that it's just a permanent symptom for her.  For these past two years, she has also had a few hospital stays due to different things: UTI, flu/dehydration, intestinal issues.  The Parkinson's Disease Dementia is blowing its way into her life now and is a constant part of her life instead of just crazy talk once in awhile.  

My reason for reaching out to you is to see if there is anyone out there who knows what can be taken for her not sleeping at night.  Is there something out there that can truly help someone in the late stages of PD to fall asleep and stay asleep at night?  She twitches and jerks so hard at night that she wakes herself up!  Then of course, she needs to potty, then get back in bed, drift off to sleep, jerk herself awake, potty, back in bed, sleep, jerk, potty, bed, sleep, jerk, potty and on and on from 10:30pm (sometimes 10:00pm) - 5:00am (sometimes 6:00am), anywhere from 3 x's to 20 x's.  Do you see my problem and it is a problem, not just an issue.  Her general practitioner prescribed Xanax.  Um, NO...then she's in a dope induced haze the next day.  Also prescribed Ambien, that would be a double NO as she had hallucinations so bad she tried to eat a plastic bottle cap.

We figured out the Sinemet needs to be taken no later than 6:00pm so it doesn't keep her awake.  And after dinner which is between 6-7, she doesn't do a lot of drinking so the initial reason is not because she has a full bladder.

I've read about everything I can get my hands on about this and everything that is going on is definitely PD related.  So I know there must be someone out there who has or is going thru the same thing that has a suggestion or a medication that we could try to give her some peace and my brother, the primary caregiver a night's sleep so he can go to work his regular 9-5 M-F job.

Any help and advice would be appreciated!

Strrme

 

 

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Slow release melatonin or Trazodone.  Have you tried an extended release sinemet at night?  Sinemet may help with the myoclonic jerks that are waking her up.

Try asking the doctor in Ask the Doctor forum or possibly pose your question on the care givers forum.

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My  mother was diagnosed 12 years ago. She  takes 1 mirapex  1 mg   we give half in the morning and half in the afternoon. Duopa Pump that delivers the medicine thru her stomach , and  Trazodone 100 mg to help her  get some sleep at night.  Trazodone has helped a lot. 

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What I have learned as caregiver for my DH diagnosed 20+ years ago is that medications should be kept as simple as possible, especially for the elderly.  More medications for the side effects of other medications is a vicious cycle.  DH's MDS did not prescribe agonists for the elderly because they often contribute to mental confusion.  Another side effect of Mirapex is sleep problems and insomnia.  DH did best in the later stages of the disease with regular sinemet every two hours during waking hours and an extended release sinemet at bedtime. We found that optimizing sinemet was the best for him.  I hope you can find a medication adjustment so that your mother and her caregiver can get sleep.

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At her age Klonopin might be okay. It's a benzo, which I normally hate, but she's old enough that it can't ruin her life like a young person. It definitely WILL help her sleep. Many MDS doctors recommend it, but it is habit forming.

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