Fact Sheets

Understanding Sleep Problems in Parkinson’s

Sleep plays an important role in overall health, including how we feel and function during the day. Many people with Parkinson’s disease (PD) have difficulty getting restful sleep. These challenges often have more than one cause. Understanding what is affecting sleep can help address the causes.

When to Talk to Your Doctor About Sleep

If any of these problems happen regularly:

  • Waking up often during the night

  • Trouble falling back asleep

  • Still feeling tired after a full night in bed

  • Sleeping more during the day or napping often

  • Acting out dreams or moving a lot during sleep

  • Strong urges to move your legs at night

Quick Facts

  • Sleep challenges affect more than 75% of people with PD.

  • Sleep is often lighter and more easily disrupted.

  • Many sleep problems improve with a combination of approaches.

Common Causes for Sleep Issues in Parkinson's

Parkinson’s affects the brain systems that help control sleep and wakefulness, which can lead to lighter, less restful sleep. Medications, mood, movement symptoms and certain sleep conditions may also play a role. Often, more than one of these factors is involved:

  • Movement symptoms at night, such as tremor, stiffness or cramping (dystonia)

  • Difficulty getting comfortable in bed because of pain or limited mobility

  • Vivid dreams or acting out dreams during sleep (REM sleep behavior disorder), which can include talking, shouting or sudden movements that may cause injury

  • Strong urges to move the legs at night (restless legs syndrome), which can make it difficult to get comfortable or fall back asleep

  • Bladder urges at night, which may be related to overactive bladder, lighter sleep, daytime low blood pressure — or a mix

  • Medications or medication timing can affect alertness or may lead to symptoms returning overnight

  • Sleep apnea, a breathing problem during sleep that becomes more common with age and can disturb restful sleep

  • Racing or repetitive thoughts when trying to fall back asleep

Ongoing trouble falling or staying asleep or not feeling rested aftersleep, is called insomnia — no matter what the cause.

Key Areas to Support Sleep

Sleep problems in Parkinson’s are often complex. Start with a conversation with your doctor, who may adjust treatment, refer you to a specialist or recommend further evaluation, such as a sleep study. Improving sleep often includes changes to routines, medication, mental health support and other treatments.

Daytime Habits
Regular wake times, natural light exposure and physical activity help support sleep at night. Sleeping too much during the day or taking long or late naps can make it harder to sleep at night.

Evening Routines
Going to bed at the same time each night helps your body know when it’s time to sleep. Dim light and calming activities in the evening signal your brain it’s time to sleep. Keep your sleep space dark, cool and quiet so you’re less likely to wake during the night

Medications
Medication timing can affect sleep. If medications wear off overnight, symptoms such as stiffness or tremor may return. Some medications may also increase alertness or cause vivid dreams. Let your doctor know if sleep problems seem related to medication timing or effects.

Emotional Health
Addressing stress, anxiety or low mood is an important part of sleep care. Options may include cognitive behavioral therapy for insomnia (CBT-I), which helps change sleep habits and thoughts about sleep. Mindfulness practices, such as slow breathing, body scan exercises or guided relaxation, can help the body wind down.

Additional Sleep Treatments
Depending on the issue, treatment options may include melatonin, CPAP therapy for sleep apnea or carefully selected sleep medications. Talk with your doctor before starting any sleep medication.

Tips for Understanding Sleep Problems

  • Consider a sleep diary. Track sleep, medications and symptoms to spot patterns and share useful details with your care team.

  • Look at sleep over time. One difficult night can affect the next day, but it may not reflect how sleep is going overall.

  • Ask a bed partner what they’ve noticed at night. Talk about what you are each experiencing and share it with your care team to help address sleep concerns.

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