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Why do you think Parkinsons patients have nightmares?
My Dad recently told me that he has woken up in the middle of the night punching the air or battling a nemesis of some kind. The nightmares worry him because he doesn’t want to hurt my Mom. Why do you think Parkinsons patients have nightmares? Is this symptom possibly associated with medication? And have you learned how to manage this issue?
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17 Replies
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I have had nightmares similar to your dad’s for many years, way before I knew I had PD. Therefore, I do not believe they are caused by medication.
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My dad acted out violently in his sleep long before his PD diagnosis. So I agree with the other responder that I don’t believe it’s the medication
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Likely due to REM Behavior Disorder which is thought to be both prodromal to PD as well as symptomatic of PD. Caused by loss of domaminergic cells in the substantia nigra of the brain.
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Melatonin and Clonazepam are cited as symptom treatment. Injury to bed partners is a concern and often drives people to seek help.
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I’ve had vivid nightmares and have acted some of them out. Tried to crawl out the window,. Up a wall.
Punched my wife.
Here’s the story: https://www.healthline.com/<wbr />health/vivid-dreams-causes#<wbr />causes
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I have had issues with nightmares (acting out, talking in my sleep) so my neurologist put me on clonazepam. It works, but I find that I wake up groggy and sluggish. Therefore, I only use it when the nightmares are severe and consistent.
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I find that melatonin is very effective and avoids the benzodiazapine.
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Hi Mary Beth,
I have this too- as Steve mentions, it’s REM Sleep Behavior Disorder and a symptom of synucleinopathy. My MDS sent me to a sleep neurologist who diagnosed me, and then had me do a sleep study to confirm. In my first RBD dream, I dreamed I was Bruce Lee, doing a slo-mo Matrix kick over a car as I took on the bad guys. Woke up kicking my poor wife in the side! Down comforter kept me from doing any damage. We bought a Bruce Lee “flying kick” t-shirt to commemorate.
I now use a weighted blanket and I respond well enough to my last dose of L-dopa, along with mirapex, to keep me from acting out (NIH did a study on L-dopa working for some patients with RBD). But as things progress, I imagine I’ll have to start taking clonazepam (I’ve just recently started to act out while asleep in the car- last fight was with a rhino). I do not respond well to melatonin.
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Also dealing with insomnia- which can be a side effect of L-dopa or a general symptom of PD. So, no sleep or sleep with nightmares?!
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I think it has to do with how our brains sort information when we’re sleeping. I had just discovered that playing games such as block games and others wherein there is sorting and arranging of items, seemed to help reduce the severity of my dreams until a certain day in January when I had been busy paying bills and didn’t take as much time playing games on my phone. That night, I dreamed that my now grown kids were little and the neighborhood we were living in was being violently attacked. I yelled for them to “GET DOWN” as I jumped to cover them. In reality, I had been sleeping on my stomach, as usual; in the process of trying to turn and jump to protect my kids, I was actually jumping up, and over, landing on the corner of my nightstand, resulting in 2 broken ribs. I now make it a priority to take the time to play games involving sorting and arranging things on my phone every day. My sleep still isn’t as sound and unbroken as I would like, but playing on my phone for a bit when I wake up at 2 or 3 in the morning along with a glass of milk helps me go back to sleep until my husband is ready to get up.
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Side effects of Sinamet, Madopar
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For my RBD, I feel poorly the next day on melatonin (if I take enough to help calm the violent REM dreams) and I really don’t like the idea of the next 30 years taking clonazepam even if it works (haven’t tried it yet). But I’ve had very good success from nighttime medical marijuana (gummies or tincture, not smoking). It doesn’t completely solve my disturbed sleep behavior, but I’d say it’s cut back episodes by about 90%. Not bad for any medication. I can be a little groggy in the morning, but much less so than on melatonin (or after a drink. Was never a big drinker, but a great “side effect” of the weed is that I’ve stopped having an evening drink without even thinking about it!). Luckily I’m in a state with legal medical weed.
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I found this medical article quite informative as to your query Mary Beth:
https://www.medicalnewstoday.com/articles/how-dreams-can-predict-parkinsons-disease#summary
medicalnewstoday.com
Dreams and PD: Can nightmares predict Parkinson's?
Some recent research has found a possible connection between distressing dreams and a faster rate of cognitive decline in Parkinson's disease. Learn more here.
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i also acted out in my sleep, still do with pd.
i found verlarian root extract helped me sleep better.
melotonian was of no use.
was so bad and still is have too sleep in separate room than spouse.
very dangerous.
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During one of my first RBD events I grabbed a board with the intent to beat off a bad guy who was attacking me. The problem was that the board was my bedside lamp and the bad guy was my wife, sleeping innocently beside me. The crash of the lamp on the floor woke us both up.
About five years into RBD we still sleep in the same bed. I take 20mg of melatonin and 500mg of magnesium citrate every night before bed, along with 200mg of carbidopa/levodopa. The C/L is really to control urinary urgency. About six hours after my last C/L dose I have to pee, then I get up every hour thereafter to pee some more. The problem then is that the dopamine that I need to control urination also shuts down the pineal gland which produces melatonin. The melatonin supplement replaces the melatonin my pineal gland is not producing. And the magnesium calms down the dreams. I read a lot in the evening and have been trying to read something non-stimulating before going to bed: no politics, no adventures, no news, no history. So far it has been working. I have gone from violent RBD every night to an occasional nonviolent episode–shouting and/or running, but not kicking and punching.
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My husband had REm behavior disorder for 2 years before I suggested he take some melatonin. It worked. We could stay in the same bed. The neurologist confirmed when he went to be diagnosed with Parkinson’s that he had REM sleep disorder and that melatonin was the best treatment for it. We were at 1 mg but have over the years slowly needed to increase to 5 mg. No other treatment has been necessary.
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I think it could be related to a B1 defficiency and also to a fight or flight adrenaline link. Howard Shifke brings up some intersting ties in his recovery. I’m not a medical Dr. But I do research regarding parkinsons.
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