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Sleep trouble

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I am wondering if my Sinemet is causing me to have trouble getting back to sleep.

I take 1/2 a 25/100 Sinemet at bedtime, 8:30 PM. I sleep until about 12:30 AM, get up to urinate, and go back to sleep. About 2:30 AM I wake up to urinate, then I take my morning meds, including levothyroxine, (for low thyroid) lisinopril (for high blood pressure), acetamenophen, and a whole 25/100 SInemet. (If I don't take the 2:30 AM Sinemet I wake up with tremors between 3-4 AM.) I also take 1 ML liquid gabapentin, because I think the Sinemet was interfering with sleep. (before I started the gabapentin, I was waking every 45 min-hr between 2:30 AM and 6 AM.)

So, after the 2:30 AM meds, I go back to bed, and sleep until 5:30 AM. When I wake up, I feel OK for the first hour or so, then I feel very fatigued. It is then a struggle to get dressed, or to do anything else beside read or use the computer. This fatigue lasts all day.

Is there anything I can do to prevent/lessen the fatigue?

Thanks, a Parkinson's patient

Edited by PDpatient
Remove personal reference (name)

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The first thing I see when I looked at your medication regime is that you take Acetaminophen and Sinemet at the same time at 2:30am. Acetaminophen is metabolized in the liver, as is the Sinemet. When they are taken together, the Acetaminophen uses all the liver enzymes to break it down and the Sinemet has to wait until the Acetaminophen is completely metabolized before the Sinemet can be metabolized. This interaction may delay the breakdown of Sinemet by at least an hour, if not more. To eliminate this there are two possible choices:

1) Take the Sinemet 30 to 60 minutes BEFORE taking the Acetaminophen.

2) Take the Sinemet 2 hours AFTER taking the Acetaminophen.

I usually recommend the first option because that way you know the Sinemet will be metabolized and start working before you take the Acetaminophen.

With the way you are taking the Sinemet and Acetaminophen at the same time now, the Sinemet is probably not beginning to work until several hours later. One of the side effects of Sinemet is sudden sleep or drowsiness. The effects can last a long while. I would try this for about a week to see if this changes the drowsiness or fatigue factor.

The other option you may want to discuss with your Dr. would be to take a medication that is a stimulant. Since Sinemet and Parkinson's Disease  can both cause tiredness, drowsiness, and fatigue, many Dr.'s will try one of these at a low dose. These products would be Nuvigil, Provigal, Ritalin, and Adderall. Some of these do come in an extended Release formula, that might be another option for you.

I hope this helps and please keep me posted.


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