Exercise and sleep in Parkinson’s

Hot off the research press is a journal article with a self-explanatory title: Effects of exercise on sleep in neurodegenerative disease.

It starts by summarising the main things that affect sleep in people with Parkinson’s, Alzheimer’s and other neurodegenerative diseases as being:

1. damage to the sleep-wake system in the brain, that affects the circadian rhythm and disrupts normal sleeping and waking patterns; and
2. “secondary mechanisms” which include a raft of things like medication side effects, having to get up to the toilet during the night, poor sleep “hygiene”, sleep-related breathing disorders, and the environment in which you try to sleep.

The paper then summarises research into exercise and sleep in different diseases, sometimes with difficulty as the many studies do vary so much in the kind of exercise protocol used, the frequency of exercise and the way that they measure the results. This post concentrates on Parkinson’s. The next post will be on Alzheimer’s.

Parkinson’s disease

There was one standout study, and it used polysomnography, an objective method of assessing sleep quality, as one of the measurement tools. There were two groups of people with Parkinson’s. One group did high intensity exercise training three times a week for 16 weeks. The other group was given expert information on how to improve sleep “hygiene”, the things that they do that lead up to going to bed and going to sleep.

You can guess the results. The exercise group had significant improvement in getting off to sleep, total sleep time and a few other important sleep measures.

Exercise improves sleep quality in Parkinson’s disease.

BUT, there is real exercise, and there is shuffling-around-the-backyard exercise.

To be effective in Parkinson’s, exercise has to push the person’s limits. Movements have to be big, heart rate has to get cracking, and the odd bead of sweat has to appear.

The next question is: Why does sleep matter in Parkinson’s disease? Sure it’s nice to have a good night’s sleep, but does it really make a difference?

Answer: It makes a huge difference.

Sleep problems will affect most people with Parkinson’s and it are very difficult to treat. Medications might help, but they “are often not effective and can cause intolerable side effects”. Sleep problem contribute in a major way to making life miserable for the person with Parkinson’s, not to mention for the person who shares the same bed.

People with Parkinson’s can improve existing sleep problems with exercise, and most likely can delay the development of worse sleep problems by being serious about exercise.

The other things that improves sleep is the Coronet. Transcranial red and near-infrared light used daily has consistently shown improvements in non-motor symptoms of Parkinson’s disease, particularly sleep. The other thing that the Coronet does is to improve apathy, a very common symptom in Parkinson’s, stripping the person of motivation and interest in life. Apathy is a barrier to exercise, and the transcranial lights reduce that barrier.

If you have Parkinson’s, there are two things you can do to protect your sleep quality and make life better. The first is to invest in very regular and very serious exercise. If you can, get good advice about what will work best for you from a neuro-physiotherapist. The second is to get a Coronet, or make your own light device from the instructions on this blog.

Reference:

Adeel A. Memon, Juliana J. Coleman, Amy W. Amara, Effects of exercise on sleep in neurodegenerative disease, Neurobiology of Disease,Volume 140,2020,104859, ISSN 0969-9961,(https://www.sciencedirect.com/science/article/pii/S0969996120301340)

Thanks to Cairns-based photographer Cris Saur on Unsplash for the stunning image of the koala.