The Michael J. Fox Foundation for Parkinson’s Research notes that one of Parkinson’s more subtle symptoms is fatigue — not your garden variety bone-tired, but fatigue on a deeper level. Your body is working overtime to accomplish even simple tasks. People with PD who experience fatigue say they feel exhausted but they don’t necessarily feel like sleeping. They’re tired physically and sometimes mentally, too. Mental fatigue can make it difficult to start projects or concentrate. Fatigue also can interfere with work, home and social life.

Fatigue can be part of Parkinson’s, but it also can come from the medications used to treat it. In some people, fatigue is a result of another Parkinson’s symptom, such as depression or apathy.

There are steps you can take to ease fatigue:

• Exercise regularly: Working out may be the last thing you feel like doing. But regular exercise, especially in the morning, can be energizing.
• Keep a schedule: Get enough sleep at night and plan daytime activities, such as exercise classes or lunch with friends. (Social activities prevent isolation, which can worsen fatigue.)
• Take short naps: In the early afternoon, quick rests can be refreshing and boost energy.
• Review your medications: Talk to your doctor about which of your Parkinson’s or other medications might be contributing to fatigue.

As you work with your doctor to pinpoint and treat the cause of your sleep problem, practising good sleep hygiene may help you get a better night’s sleep.

Keep a sleep diary or use technology to track your sleep. Important notes to record include the time you go to bed and get up, how many times you awaken during the night and why, and how many hours you sleep. Keep track of the caffeinated beverages you drink (both how many and at what time of day), if you nap and your exercise routine. These notes will help you to have a productive conversation with your doctor about your sleep.

Limit daytime naps. Sleeping too much during the day, especially late in the day will likely prevent you from sleeping well at night.

Avoid caffeine, alcohol and exercise later in the day. Caffeine consumed in the afternoon can keep you awake at night. Although alcohol may seem to help you fall asleep more easily, it may interrupt your sleep later in the night. Working out regularly earlier in the day can improve sleep overall but exercising too close to bedtime might make it harder to fall asleep.

Don’t drink too much fluid before bed. This is especially important if you experience frequent nighttime urination.

Use the bedroom only for sleep and intimacy. Don’t watch television, read, use your telephone or do anything other than sleep in bed. When you use your bed only for sleep, your body and mind will automatically know what’s supposed to happen when you get into bed.

Create a bedtime routine. An hour before bed, start to prepare for sleep. Turn off the television, computer and other electronics that emit stimulating light. Take a warm bath, drink a cup of decaffeinated tea or read something for fun. Get your body and mind in the habit of winding down and preparing for sleep.

Keep a regular schedule. Go to sleep and get up at around the same time every day, even on the weekends.