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Since sleep disturbances may be related to Parkinson's disease medications, the doctor may adjust dosages or even change medications. If the patient has problems with excessive daytime sleepiness, the doctor may prescribe a stimulant.

There are also modifications that can be made in the patient's sleeping environment. These include:

• Use of satin sheets which are slippery and may make it easier for the patient with stiffness to move or get comfortable in bed
• Using well-placed pillows to help the person stay in a comfortable position and prevent them from rolling back into an uncomfortable position

It is important to discuss any changes in sleep patterns with your doctor since lack of restful sleep can cause significant interference in daytime and nighttime quality of life not only for the patient with Parkinson's disease but also for the caregiver. The caregiver needs to get an adequate amount of sleep to remain strong and supportive. Rehabilitation professionals should be able to make suggestions to help the caregiver in this area.

Constipation

This problem may be alleviated by ensuring that the Parkinson's disease patient drink adequate amounts of fluids and maintain a high-fiber diet of fruits and vegetables.

Frequent Urination

A urologist is helpful in evaluating this disorder and suggesting effective treatments. The doctor must determine if the problem is due to medications, infection, comorbid symptoms of aging (e.g., enlarged prostate), or multi-system atrophy (Shy Drager Syndrome) which shares many similar symptoms with Parkinson's disease such as slow movement, stiff muscles, and mild tremors. There are medications and modifications in daily life that can be suggested for addressing bladder issues as Parkinson's disease progresses.

Weight Loss

Since Parkinson's disease patients are particularly at risk for weight loss, it is important to take steps to manage this issue. Weight loss is partially related to problems that develop with muscles involved in swallowing which makes eating more difficult. Modifications can be made by a speech therapist who may be able to help the patient optimize muscle control or a nutritionist who can teach the patient to modify eating habits so the greatest nutritive benefit is gained.

Helpful suggestions may include:

• Supplementing meals with high calorie drinks
• Frequent small meals
• Modifying the consistency of foods given to the patient to minimize choking or coughing

Since thirst normally diminishes with age and Parkinson's disease medications can cause dehydration, it is critical for the Parkinson's disease patient to drink adequate amounts of water.

Shortness of Breath

Shortness of breath may be partially controlled by modifying dosage and scheduling of Parkinson's disease medications. Physical therapy is also important in order for the patient to optimize tone and flexibility of the chest muscles.

Visual Disturbances

Modification of the environment may help minimize disturbances of vision. Some suggestions include:

• Brighter lights
• Greater contrast of color between floor and furniture
• Greater contrast where there are changes on the floor (e.g., steps, rugs, etc.)