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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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As caregiver of DH with Parkinson's, diagnosed 20+ years, I have found that in regards to medication, simple is better.  For DH, agonists including Mirapex, caused more problems with side effects than benefits.  DH's MDS did not prescribe agonists for elderly patients because of risk of worsening dementia. One of the side effects of Mirapex is sleep problems.  DH responded best with regular sinemet at two hour intervals and an extended release sinemet at bedtime.  Unfortunately, in my opinion, the tendency is to add more medications that cause side effects rather than optimizing sinemet.  I so hope you can get her medication adjusted so that both your mother and the caregiver can have rest.

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My husband takes Trazadone for sleep. It doesn’t make him groggy the next day. He takes it about fifteen to twenty minutes before bed. He rarely wakes up even to use the bathroom. He doesn’t tremor at all during the night.

I hope you get some relief for her soon. It took a long time for us to find a sleep drug that worked. Good luck.

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My dad takes trazodone and melatonin at bedtime, but it's hit or miss if they work.  Many nights he's up at least half the night.  Now that his dementia is worse he lives at a memory care facility - we tried taking care of him but weren't able to do it & work too.  Having PD with no dementia, might be possible to get a night's sleep but with the dementia, forget it!  :(

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