It feels like a vicious cycle–you need restful sleep to better manage Parkinson's, yet the disease itself can keep you from getting a good night's sleep. Sleep problems are among the earliest symptoms of Parkinson's disease and one of the reasons that 75% of people with Parkinson's say they are sleepy during the day. Adding fuel to the fire is the fact that some Parkinson's medications can make you drowsy during the day. If you are not getting enough sleep at night, you can get into an exhausting cycle of not being able to stay awake during the day and not being able to get to sleep or stay asleep at night. Why You Struggle to Sleep The stiffness, pain, rigidity, and tremors of Parkinson's disease make it hard to get comfortable in bed–just rolling over to find a more comfortable position can be a chore. But that's not all you have to deal with. Here are some other Parkinson's symptoms that can keep you up at night: Insomnia. You may have a hard time simply falling asleep. Nightmares. Vivid nightmares are common in people with Parkinson's. They can seem so real that they cause you to act out your dreams. Sleep disorders. Some disorders that interfere with sleep are more common in people with Parkinson's. These include restless legs syndrome, periodic leg movement disorder, and sleep apnea. Nocturia. Nocturia means having to urinate at night. People with Parkinson's disease have a decreased ability to hold their urine. That could mean interrupting your sleep to get to the bathroom. Depression. This is another condition that is more common in Parkinson's. Depression can make you sleepy during the day and give you insomnia at night. Tips for Better Sleep The best place to start is with your doctor, who may be able to change or adjust your Parkinson's medications so that they interfere with sleep less. In some cases, you might be able to take a medication that helps you stay awake during the day so you sleep better at night. If you have a sleep disorder or depression, other medications may help. Be sure to ask your doctor before taking any over-the-counter sleep medications. Many contain an antihistamine, which can actually make Parkinson's symptoms worse. There are also sleep strategies you can try for yourself: Stick to a regular sleep schedule. Getting up and going to bed at the same time every day, even on weekends, can help regulate your sleep cycle. Avoid caffeine for at least six hours before bedtime. That means chocolate as well as coffee, tea, and sodas with caffeine. Stay active during the day and avoid taking naps. The energy you expend during the day will leave you more tired at night. Complete your exercise regimen at least 3 hours before bedtime to optimize pre-sleep relaxation. Get outside for some exercise every day. Morning sunshine helps set your biological clock. Limit fluids in the evening. Avoid drinking a lot of fluid in the hours before bed to cut down on the need to urinate in the middle of the night. Try a relaxation routine. Get in the habit of treating yourself before bed to a relaxing activity such as a hot bath or shower or a gentle massage. Sleep in satin. Satin sheets and pajamas make it a lot easier to move around in bed and get into and out of bed. Make your bedroom a sleep oasis. Make sure it is a comfortable temperature, dark, and quiet. Avoid using your bedroom for working or watching television. If you have Parkinson's disease, trouble getting enough sleep can really impact your quality of life. With some help from your doctor and some good sleep management, you can take back the night. Key Takeaways Daytime sleepiness and nighttime wakefulness are common in Parkinson's disease. Identify possible causes including Parkinson's symptoms and its medications, depression, and sleep disorders that are more common in people with Parkinson's. Talk with your doctor about medical options before taking any over-the-counter sleep medications. Practice good sleep habits to get back into a healthy sleep cycle.