Good Morning Parkinson’s: A Great Start to the Day

Good Morning Parkinson’s is a resource for people with Parkinson’s disease (PD), their families and caregivers to learn more about PD and ‘morning off’, as well as things you can do to help make your mornings more comfortable. Morning off episodes, or early-morning akinesia, occur when levels of PD medicine drop during the night, and can be one of the most frustrating complications of PD.

Learn more about PD and morning off by reading the information below and taking a look at some of our downloadable materials.

About PD
Parkinson’s disease (PD) is one of the most common neurological (nerve cell) disorders. It affects approximately 6.3 million men and women worldwide,1 with 4 to 20 new cases reported per 100,000 people per year.2  

PD is a chronic and progressive brain disease that most commonly affects those over the age of 60,3 though rarer forms of the disease can develop before the age of 40.4 Because the risk of developing PD increases with age, the fact that more people are now living into old age means that the overall number of people with PD is also rising.5 

People with PD have difficulty controlling their body movements, and symptoms become worse as the condition progresses. Ultimately, the disease impairs the patient’s ability to function in daily life situations.

Symptoms of PD
Classic symptoms of PD – so-called ‘motor’ (movement-related) symptoms – include tremor, slowness of movement, muscle stiffness, and balance problems. In addition, non-motor symptoms are also common, for example, depression, dementia, fatigue, pain, sleep problems and dysfunction in the body’s autonomic systems (such as digestion and blood pressure).6 All of these add considerably to the disease burden.

PD is a progressive disorder and, over time, new symptoms appear and existing symptoms slowly become more severe. However, it is not a terminal illness – people can live for some 15 to 25 years from the point of diagnosis.7

Treatment
At present, there is no cure for PD, but once a diagnosis has been made by a medical professional, symptoms can be treated effectively for some time. However, progression of the disease will lead to re-concurrence of symptoms and/or symptoms associated with medications (e.g. fluctuations). The aim of treatment is to control and relieve symptoms, so that people can continue to function and enjoy a reasonable quality of life for as long as possible.

Treatment for PD normally involves drug therapy and, in some cases, surgery. In addition to this, physical exercise, diet, complementary therapies, emotional support and strong relationships all play important roles. Understanding PD, relating to the new situation in life, and learning to accept new goals and challenges, are almost as important as practical management of the disease.

Morning off
Symptoms can be treated effectively in most cases with drug therapy; however, the effects of this therapy can wear off during the night as levels of medication drop, meaning patients typically present with poor motor function in the morning when they wake up (called morning off) before the next dose of therapy is due.8 These ‘off’ episodes are among the most frustrating and challenging complications of PD.9

Further resources
There is plenty of information available on PD and morning off. Feel free to download and share the following resources to help us raise awareness of morning off in PD.

References

  1. European Brain Council. Parkinson’s disease Fact Sheet. Available at: http://www.europeanbraincouncil.org/pdfs/Documents/Parkinson's%20fact%20sheet%20July%202011.pdf Last accessed: August 2015.
  2. de Lau LML, Breteler Monique MB. Epidemiology of Parkinson's disease. Lancet Neurology, 2006;5(6):525-535.
  3. Weintraub D, Comella CL, Horn S. Parkinson's disease-Part 1: Pathophysiology, symptoms, burden, diagnosis, and assessment. Am J Manag Care. 2008;14(2 Suppl):S40-8.
  4. Grimes DA. Parkinson’s disease: a guide to treatments, therapies and controlling symptoms. London: Constable & Robinson Ltd, 2004.
  5. Dorsey ER, Constantinescu R, Thompson JP, Biglan KM, Holloway RG, Kieburtz K, Marshall FJ, Ravina BM, Schifitto G, Siderowf A, Tanner CM. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030 Neurology 2007;68(5):384-386.
  6. Parkinson’s UK. Parkinson’s symptoms. Available at: http://www.parkinsons.org.uk/content/parkinsons-symptoms Last accessed February 2016.
  7. Poewe W, Mahlknecht The clinical progression of Parkinson's disease. Park and Rel Dis 2009;15(Suppl 4):S28-S32.
  8. Parkinson’s Western Australia. Wearing off. Available at: http://www.parkinsonswa.org.au/what_is_parkinsons/wearing_off Last accessed August 2015.
  9. Rizos A et al. Characterizing motor and non-motor aspects of early-morning off periods in Parkinson's disease: an international multicenter study. Parkinsonism Relat Disord. 2014;20(11):1231-5. 
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