I experience a phenomenon called "sleep benefit". When I wake up from night time sleep or even a day time nap, my PD symptoms have noticeably diminished. My symptoms, e.g. tremors and a lack of coordination in left hand resume after about an hour. This occurs although I haven't taken Sinemet for at least 12 hours.

I found a recent paper on Sleep Benefit and PD (Parkinsonism Relat Disord. 2013 Jul;19(7):654-9. (I have a link but, For some dumb reason, I have to have 10 posts before I can submit a link)

I've tried to summarize possible causes and wonder if PWP who experience this phenomenon have any ideas based on personal experience?

Excerpt from paper:

"Upon awaking in the morning some patients experience good mobility, as if they are in an "on" state induced by medication, contrary to what would be expected after a night without medication. This intriguing phenomenon is known as sleep benefit."

Possible mechanisms:

1. Function of circadian timing unrelated to sleep. But daytime naps can provide "sleep benefit" regardless of circadian timing. I have experienced this and do not agree with this hypothesis.

2. Improved dopaminergic function as a result of increased dopamine storage. But, not all PWP experience sleep benefit from both nightime sleep and daytime naps. There are some PWP who only experience sleep benefit from a daytime nap.

3. Since PWP with sleep benefit tend to have more sleep disruption, i.e more nightime awakenings, sleep benefit is independent from sleep quality and sleep deprivation can improve sleep benefit. But a recent study showed the experience of sleep deprivation is a function of a downregulation of dopamine receptors instead of an increase in dopamine levels.

4. Another idea:
A.) A byproduct of cell metabolism is adenosine (ATP pathway).
B.) Accumulation of adenosine causes sleep.
C. During certain periods of sleep where brain activity is minimal, adenosine levels are at their lowest causing you to wake up. So you wake up when adenosine and PD symptoms are minimal. Is there an association? There is lots of literature out about the therapeutic effects of adenosine receptor antagonists. Do adenosine antagonists such as caffeine make your symptoms worse? Wonder how adenosine receptor agonists would affect things.

Just wondering

Most days I get a good sleep benefit over night but not from my afternoon nap. I have noticed from my nocturnal potty breaks that the effect takes place in the morning and doesn't accumulate through the night.

My sleep benefit lasts for about 3 hours in the morning.
I wish I had time to take a nap!

That's pretty good. How many hrs of sleep do you get and what time do you wake up?

I usually sleep for about 7 hrs..
I'm up at 5:45 -6am. I usually feel pretty good and functional until about 9am. Sometimes later. I'm also very busy in the morning getting my 6 year old up and fed and ready for school.

I'm finding the sleep benefit interesting as I experience the same thing. This morning I felt pretty good for about 4 hours before tremors increased. I took an hour nap in the afternoon with no benefit noted afterwards. However after an hour of exercising (45 min on treadmill and 20 min on theracycle) I noticed a small benefit. After a glass of wine I also have a decrease in tremors. I'm not a great sleeper so benefits aren't related to a good night's sleep.

I get 20-30 minutes in the morning.

I've often wondered if this is also related to another phenomenon reported by some people on this forum, regarding forgetting or not taking meds, and once the initial off state passes, being able to do a day or two without meds before full blown symptoms re-emerge.

My brother was always better functioning after his meds wore off during the night..he could get up and walk without falling and mind was clearer. I told my sister in law to cut back on his meds alittle during the day and that helped some also. He was on so many things...quite an overload to me. He never would try the fava tincture...said the doctors were taking good care of him. I think things would have turned out differently had he gone natural , but we shall never know. With me, my extreme morning stretches and exercise before leaving the bed frees something in my body and makes my dry eyes pour water and the pain and stiffnes vanish. I am so thankful to God for all the past experiences in my life that taught me what I needed to learn to deal with PD (from herbals/ accidents/massage therapy /physical therapy work with patients and therapists for years and even kayaking....it has all played a part in what is now my main focus in life...staying well and being able to help others fighting PD just like me.....be strong, never give up and do something for someone else today....makes your life better and remember to smile and laugh

I also get 20-30 min w/o tremors. Drinking coffee (caffeine) makes things worse. Since caffeine is an adenosine receptor antagonist it tells your brain to wake up. So I was wondering if an adenosine receptor agonist (which tells your brain to get some seep) would be beneficial. One such agonist is lemonene, which is an oil in citrus fruit peels.

Therefore has anyone had any benefit from drinking lemon or orange peel extract?

I've been experimenting with d-limonene for a few weeks but haven't noticed anything.