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Why do physicians recommend elevating the head of the bed?

Environmental modifications are important for Parkinson's Disease patients. These include elevating the head of the bed, allowing the patient to rise easily. In certain cases elevating the head of the bed also alleviates drug inducted nausea. Other environmental modifications include various aids to independent living such as lift chairs, raised toilet seats, grab bars, ramps, and large handled utensils which are readily available at home medical equipment dealers.

In addition, some PD patients suffer from low blood pressure upon sitting up or standing (orthostatic hypotension) sometimes caused by the disease and other times as a drug side effect. Some remedies for this include elevating the head of the bed, drinking water, ensuring adequate salt intake and wearing compression stockings when going to bed.

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About Parkinson's disease

Parkinson's disease (PD), is one of many illnesses that fall under the category of Parkinsonism, which is characterized by rigid or slow movements and tremors. Approximately 80% of Parkinsonism is of unknown cause and is represented by changes in the brain's motor control areas. PD usually occurs between the ages of 40 and 70 years with most occurring after age 55, and affecting men and women equally.

Parkinson's disease results from the death of nerve cells in a small area of the brain called the substantial nigra, which is essential for normal movement. This area becomes depleted of neurotransmitter dopamine. By the time a person notices symptoms of the disease, up to half of these dopamine-producing cells have already died. As more cells die, the symptoms worsen.

Symptoms

The first symptom noticed by a person is a tremor at rest, very often in the hands. Other symptoms include gait disturbances, loss of speech tonality, dementia, eye problems, swallowing, elimination problems, sensory illusions such as unpleasant cold or heat sensations, and sleep disturbances. Other factors can cause the remaining 20% of Parkinsonism including toxins, infections, vascular problems, metabolic disorders or drug-induced.

Treatment options

Parkinson's disease progresses gradually making it difficult to diagnose early. If you suspect that you have PD, you should see a neurologist with experience with PD, who will review your medications to rule out drug side effects as a cause and perform an examination.

Laboratory tests and various imaging techniques such as magnetic resonance imaging (MRI) may be performed to detect causes for parkinsonism.

There is no cure for Parkinson's disease, but certain treatments with drugs or surgery can be beneficial. The most widely used medicines are a combination of levodopa and carbidopa. This combination creates the foundation for the brain to make dopamine, which is provided to the brain cells.


Drug side effects

Drug side effects can be a significant problem in the treatment of PD. Some of the more common problems include dose-related issues with Levodopa causing an inability to move early in the morning restlessness and/or a loss of the beneficial effects of sleep, Orthostatic hypotention which is low blood pressure upon sitting up or standing which can be caused by the PD or by medications, nausea, constipation, psychosis, hallucinations, depression, sleep disorders, sleep fragmentation, vivid dreams and nocturnal vocalizations.

Non-drug management

From the outset, it is important to provide support for the patient in the form of education, environmental modifications, transportation, dental care, nutritional and therapy including speech, physical, psychological and occupational.

Surgery

Surgery can help people with PD when medication is not controlling the disease effectively. One form involves destroying a tiny part of the brain, alleviating some of the rigidity and tremor associated with PD. This has been effective in over 90% of the procedures. Newer procedures include deep-brain stimulation (DBS), transplantation of adrenal gland cells or fetal nerve cells and electromagnetic brain stimulation.

For more information about treatment and drugs for PD please refer to our links page Senior Living: Treating Parkinson's Disease.

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