[rd42]

Is insomnia a symptom of PD or just a side effect of the symptoms and meds that skip hand and hand with PD?

32 dx'd 2 years ago, taking Azilect for 9 months, insomnia started last week.

yawn,
Robert

[K.Ibsen]

I've been thinking about asking about insomnia, too. I don't recall whether it is one of the PD symptoms, but there are definitely PD symptoms that can keep one awake, such as myoclonic jerks that afflict me considerably.

I met with my doctor today and asked him about my insomnia. He suggested that the L-Dopa could have something to do with it. I also have some new stress in my life, and that never helps. I've also had problems with various anti-depressants that seem to keep me awake--which is paradoxical, because they make most people drowsy.

Anyway, he prescribed Desyrel (trazodone), which is an antidepressant. I just took it for the first time a few minutes ago, along with my usual dose of Klonopin (clonazapam). I hope it works.

Karl

[Jaye]

In the words of an Italian study ( Arch Gerontol Geriatr. 2007 Aug 30; [Epub ahead of print]), "Although in the early stage of the disease, a high presence of behavioral disturbances was detected, depression and anxiety were the most common disorders, followed by apathy and sleep disturbances." The authors were grouping Parkinson's in with some other similar disorders, but they hadn't found a lot of other studies to use for comparison and said the area warranted further study.

This is in accordance with what I've experienced and heard about here. I'm retired, so I've stopped worrying about it. I've had some meds that had the opposite of normal effect with regard to sleep; doc said just take them at the opposite time of day.

Another thing to be aware of is that sleep disturbances are common in endogenous depression, I've been told by doctors and a psychologist.

[wwally0]

I'm going into my 7th year with PD and these are some adjustments I had to make along with some observations. The agonist Requip sedated me from day 1 and it never let up. I needed to be alert and awake for my work day so my neuro prescribed Alertec (a stimulant) which helped my day considerably. As far as I'm concerned Sinemet is cumulative with each dose so it acts as a stimulant for me and increasingly does as the day progresses. I ended up taking my evening Sinemet earlier which helped with sleep. For a couple of years I took Imovane (sleeping pill) at bedtime till I became immune to it and for the past couple of years I take a Desyrel (trazodone), as K.Ibsen does but I supplement mine with a bedtime cup of tea with an once and a half of rum (not for everyone but works for me). The only disagreement I ever had with my neuro is when he wanted to send me for a sleep study and check for sleep apnea. I refused to drive 5 hours for some one to fit me up with a machine when 1. I never lost a wink until I started PD meds and the machine I'm speaking of sounds like a 747. I believe that the futzing we do with medication to keep mobile also comes in handy for sleep. The odd time I'm awake when I shouldn’t be, I find my pillows, blanket and a good movie. If you are up for many hours a small snack will stop a hungry stomach for keeping you awake longer. If PD symptoms are kicking you out of bed I see that some folks here take Sinemet CR - the long acting version of the drug to get their night in. It's trial and error but you'll tweak things to work the best way for you. Guy

[K.Ibsen]

Well, the trazadone seemed to work. Last night was the first time I tried it. It seemed to take a long time to take effect, however. I had noticed that same delayed response with the clonazepam, too.

I too have noticed that sinemet seems to have a stimulant effect. With my current dosing of sinemet, I don't get anywhere near as tired during the day as I was with the lower dose.

I also recall having recently read that either carbidopa or levodopa can effect digestion. My memory isn't what it used to be, so I can't recall either the specifics or where I read it. I'll keep looking. Anyway, I was wondering if taking my "go to sleep" medications at the same time that I take my evening dose of sinemet may be causing the former to be less effective. So, if correct, this may be another reason to put some time between doses of sinemet and my clonazepam and trazadone.

Tonight I'll try taking my sinemet an hour before taking my clonazepam and trazadone. There may be a down-side effect of being a bit more "off" in the morning before I take my first dose of sinemet, but a good sleep is probably worth it.

Karl

[Jaye]

To aid your search, Karl, carbidopa is a dopamine decarboxylase inhibitor, which keeps some (I don't know how much) of the levodopa in the Sinemet from being processed into dopamine by the digestive tract; this saves it for processing in the brain where it will do some good. I'm sure one of the big charity sites has a better explanation--NPF at www.parkinsons.org or Mike Fox's site or PDF etc. You might have the background to follow the pharmaceutical description in the monograph at www.rxlist.com .

By the way, for all readers, those drug monographs take some getting used to if you read the adverse effects parts. Everything sounds really scary when you look at every single possibility in minute detail. Keep telling yourself that every medicine at the right dose is a poison, but also every poison at the right dose is a medicine. Or something like that It's 2:30 am.

Jaye