3 complementary therapies for Parkinson’s disease and sleep

Special reports

Author: European Parkinson's Disease AssociationPublished: 20 May 2021

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Barbara Morandi does outdoor yoga.

If your Parkinson’s disease is keeping you awake at night, you might have considered trying complementary therapies. But because many have anecdotal, rather than scientific, evidence backing them up, it can be difficult to know how effective they are. We find out more about shiatsu massage, CBD oil and Ayurveda


1. Shiatsu therapy

A popular example of ‘needle-free acupuncture’, or acupressure, shiatsu is a Japanese treatment wherein a therapist uses their fingers and hands to apply pressure to various points on the body to improve the flow of energy. Practitioners believe it can promote healing and relieve pain, and for people with Parkinson’s disease, benefits are said to include better sleep quality.

However, it should be avoided if you have weak bones or certain blood disorders, and you should inform your therapist if you could be pregnant.

Shiatsu therapist Barbara Morandi (pictured above) practices the Masunaga style of shiatsu and specialised in neurological conditions as part of her training. She thinks that shiatsu is of great help to people with Parkinson’s because it can help with removing stiffness and pain – symptoms which can affect sleep.

A massager applies pressure to a man's back with their thumbs.

Shiatsu is a Japanese treatment that involves applying pressure to various points on the body.

“Shiatsu is of particular benefit to contracted muscles – a symptom of Parkinson’s disease,” says Barbara.

“It helps you reconnect with your whole body and boundaries, giving deep relaxation for muscles and the nervous system. I’ve found that people who have had shiatsu benefit from more relaxed muscles. And when you relax the muscles, your nerves struggle less and you have less pain.”

2. CBD oil

Cannabis contains about 100 different compounds. Of these, two of the most common are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC affects brain function and is thought to be beneficial for pain, nausea and muscle spasms, but it also affects mental processes, including behaviour and consciousness.

CBD, on the other hand, does not affect have psychoactive properties, and some think it could be beneficial for people with Parkinson’s disease. Studies suggest it may be effective in improving sleep for people with the condition, but research is still in its early stages and there are no guidelines on dosage.

Dr Susan Fox, a neurologist at Toronto’s University Health Network, has been researching cannabis products and Parkinson’s disease for nearly 20 years. Following the licensing of cannabis products for personal use in Ontario, Canada, Fox is running a clinical trial on the safety and tolerability of a CBD oil for 15 patients with Parkinson’s disease.

Susan Fox smiles for a photo.

Dr Susan Fox has researched cannabis products and Parkinson’s disease for almost two decades.

“The primary aim of this is to see if it helps pain in Parkinson’s disease, but one of the secondary outcome measures will be, does it help sleep as well?” she says.

One of the problems with cannabis products is that they vary widely, she adds. In some, either THC or CBD – or both – may be present, and in varying concentrations, which makes clinical assessment difficult.

“There’s a whole problem here in that when people say, ‘Well, could I use some cannabis for my sleep?’, the question is, if they go to a shop and buy it, what are they actually getting?”

Another factor to consider is legality. In some countries cannabis products are legal for personal use, but in others they remain illegal. There are also further regulations; in most European countries, for example, CBD oils must contain no more than 0.2% THC.

Dr Fox points out that even if a cannabis product does improve sleep, there could be other unwelcome side effects for people with Parkinson’s, including hallucinations and dizziness. “I’m always very, very cautious with my patients when they come and ask me about cannabis products,” she says.

Dr Fox suggests one alternative option may be to try a licensed pharmacological cannabis product instead, which can be prescribed through healthcare providers. However, use in Parkinson’s disease is currently ‘off-label’ and there is limited evidence of benefits.

3. Ayurveda treatments

Ayurveda is a holistic medicine system which began in India thousands of years ago. Its emphasis is on the balance between the body, mind and spirit to promote wellbeing – including physical strength and calmness.

Massimiliano Iachini, vice director of the Italian young onset Parkinson’s association Associazione Italiana Giovani Parkinsonianihas regularly travelled to Kerala, India, to benefit from Ayurveda therapies – which he says help tremendously with his sleep and health.

Massimiliano Iachini undergoing Shirodhara, an Ayurvedic healing technique, in Kerala, India.

Massimiliano Iachini undergoing Shirodhara, an Ayurvedic healing technique, in Kerala, India.

“I have a consultation with a range of doctors who examine all aspects of my lifestyle and health,” he says. They then recommend a course of therapy which includes body and head massages with oils along with meditation, yoga and herbal medicine. He comes back to Italy with specially prescribed oils which he massages into his head before sleeping.

“For me it’s like magic,” he says. “It has changed my lifestyle and really transformed my sleep. In particular, it helps reduce the over-stimulation in my brain which is made worse by our modern-day lifestyle. In fact, it’s been so life-changing that it’s my dream to build a centre for Ayurveda in Italy, where people can come to receive treatment.”

If you are considering a complementary therapy, always consult your healthcare practitioner beforehand, in case there could be harmful side effects or interactions with medication you are already taking.

Take part in Parkinson’s Sleep Well Week

If you have Parkinson’s disease and find it difficult to sleep, you’re not alone. Up to 90% of people with the condition are similarly affected.

Identifying the root causes of sleep problems is the first step to solving the issue. Disrupted sleep can be due to a number of things such as poor sleep hygiene, the symptoms of Parkinson’s, or medicines for controlling it. 

From 24–30 May, take part in the EPDA’s ‘Parkinson’s Sleep Well Week’, part of the EPDA’s month-long ‘Sleep Well’ campaign, and join other people with Parkinson’s to share sleep tips and ideas. For more resources to improve your sleep habits and help you sleep well, please visit the EPDA website.


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