You used to shift position in your sleep without thinking about it and get up in the morning without giving it a second thought. As Parkinson’s progresses, those automatic movements start to fail. Taking a motion you used to do in one go and splitting it into several steps, each one done consciously, makes it much easier.
Why you stiffen up so much more at night
Nocturnal akinesiaDifficulty turning over or changing position during sleep. Up to 70% of people in the mid-stages and beyond are reported to experience it, and when severe it carries a risk of complications such as pressure sores and aspiration pneumonia.Learn more — not being able to shift your body while you sleep — is reported in up to 70% of people in the mid-stages and beyond. In one survey, 65% said they had trouble rolling over in bed, so it is genuinely common. Staying pressed in one position for hours also carries a risk of pressure sores, which makes this more than a matter of discomfort. Some studies report that taking a slow-release (extended-release) levodopa formulation at bedtime helps, so if you stiffen up badly at night, it is worth asking your care team about adjusting the timing or the formulation.
To roll over, start with your knees
Lying on your back, bend your knees and plant your feet on the mattress. Keep your shoulders where they are and slowly roll only your knees from side to side. This helps you recover the feel of turning over. Repeating it 10 times to each side makes it easier to actually use that movement when you roll over for real.
Break getting up into steps
Don’t try to go straight from lying flat to sitting up. If you raise the head of the bed to about 30 to 45 degrees and get into a half-sitting position first, moving to the edge of the bed afterwards is far easier. If your bed doesn’t adjust electrically, stacking several cushions behind your back gets you into a similar position.
Your bedding makes a difference
Smooth sheets, such as satin or silk, let your body glide across the fabric, which makes turning over easier. But wearing satin pajamas with satin sheets leaves so little friction that you can slide out of bed in your sleep — it is safer to have only one of the two in a smooth material.
You can add equipment
A bed rail gives you something to brace against while you change position or get up, though you need a certain amount of arm strength to pull yourself up with it for it to be effective. Transfer boards, slide sheets and belts with handles can also help depending on the situation. An occupational therapist or physical therapist is the right person to ask about which equipment fits you.
If someone is helping you up, use a transfer belt
When getting up alone isn’t possible and someone has to lift and move you, a transfer belt (gait belt) worn around the waist makes it far safer. The person helping holds the belt with one hand and supports under the hips with the other, lifting the hips as though turning a large wheel. They should bend at the knees and lift with their legs, not bend at the waist — that protects their own back from injury. Agreeing on a signal before you move, something like “up together on one, two, three,” so you both apply effort at the same moment, takes the strain off both of you.
Work with your medication schedule
If you can, change position or get out of bed while your medication is working well — it is much easier. If you have to move during an “off” period, when the medication has worn off, plan to lean more on the mechanical help the bed gives you (an adjustable head section, a bed rail) rather than your own strength, and to move more slowly than usual.
This article is not a substitute for medical diagnosis or treatment. If moving in bed is often hard or feels unsafe, please talk with a physical therapist or occupational therapist.
