Insomnia and Hunger
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Until recently, I seemed to have no problem falling asleep at night and not waking up until the next morning. I rarely needed to get out of bed to use the bathroom, and I had no problem with dreams or hunger.
However, increasingly these days I find I can’t go to sleep at the hour I’m used to (10:00-ish) because I have intense hunger. If I don’t get out of bed and go to the kitchen to satisfy it (eating, say, some bread and butter, or crackers and peanut butter), I lie there in bed for hours, wide awake. Eventually, I convince myself that it’s smarter to eat something now and sleep immediately afterward, so I do just that, even if it’s after midnight.
Last night, for the first time that I can remember, I snacked at 10:00 and fell asleep immediately afterward, but I woke up at 2:00 with even more severe hunger pangs. So from 2:00 until dawn (4:30-ish), I stuffed myself with lots of food: bread, butter, 2 mini-cucumbers, dark chocolate, and other stuff I can’t remember now.
What to do?
I went online this afternoon to see what AI had to tell me. Here’s what I learned. I’ll keep everything AI writes in its original fonts, which include bold and italics. I’ll put my own verbiage in underline.
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Insomnia and uncontrollable nighttime hunger in Parkinson’s disease are frequently linked to medication side effects, unaddressed motor symptoms (like stiffness), or compulsive eating behaviors. To manage both effectively, you should optimize your daytime medication timing, eat a stable diet, and consume only very specific, small snacks at night.
- Managing Nighttime Hunger
If you experience intense, unjustified hunger feelings at night, it could be a side effect of dopamine-related medications, or a symptom of insufficient calorie intake during the day.
- Avoid large meals: Eating big meals close to bedtime worsens sleep fragmentation.
- Small, strategic snacks: If you feel hungry at night, forum users and sleep experts on the Parkinson’s UK Forum and Reddit r/Parkinsons agree that a tiny, low-sugar, non-caffeinated snack helps calm the feeling without triggering insomnia. Good options include a glass of warm milk, a slice of whole-grain toast, or a small handful of tree nuts like almonds or pistachios.
- Medication adjustments: Some dopamine agonists are known to occasionally cause Sleep-Related Eating Disorder (SRED). If this feeling is uncontrollable, your neurologist can evaluate whether your medication schedule needs adjusting.
- Addressing Parkinson’s Insomnia
- Protein timing: Be mindful of how close you take your levodopa medication to protein-rich meals (meat, fish, eggs, dairy, nuts) as protein can block the absorption of the drug. Taking medications too late in the evening might also be associated with periods of insomnia.
- Rule out motor symptoms: Often, “insomnia” in Parkinson’s is actually sleep fragmentation caused by medications wearing off, which results in stiffness or an inability to turn over in bed. Speak with your doctor about adding a longer-acting medication at bedtime to help with nocturnal immobility.
- Strict sleep hygiene: Use the bed only for sleep and avoid screens or caffeine after noon. Maintain a cool, dark, and quiet bedroom.
Could you tell me:
- What specific Parkinson’s medications are you taking?
- Does the hunger feel like an intense physical craving, or does your body feel physically weak/shaky?
I can help you prepare questions to discuss with your neurologist or dietitian.
My Response:
My main Parkinson’s drug is Crexont, which I take in the morning, at 1:00 p.m., and again at 7:00 p.m. I think I can stop taking the 7:00 p.m. Crexont, however. Also, my hunger feels like an intense, physical craving.
You should not abruptly stop or change the timing of your 7:00 p.m. Crexont dose without your neurologist’s explicit guidance.
Crexont is an extended-release formulation of carbidopa/levodopa. Stopping it suddenly can trigger severe, dangerous withdrawal symptoms or cause your motor stiffness to return aggressively overnight.
Furthermore, recent clinical data show that Crexont actually improves sleep quality by keeping dopamine levels stable through the night, reducing the nocturnal rigidity that often causes insomnia.
💊 1. Why You Must Not Stop the 7:00 p.m. Dose On Your Own
- Risk of Neuroleptic Malignant Syndrome: Abruptly dropping a levodopa dose can cause a rare but life-threatening reaction featuring high fever, severe muscle rigidity, and confusion.
- Worsened Insomnia: While it seems logical that less medication at night equals better sleep, the opposite is often true in Parkinson’s. Dropping the 7:00 p.m. dose will likely cause your dopamine levels to crash by midnight, leaving you physically unable to turn over or get comfortable, severely worsening your insomnia.
- Long-Acting Nature: Because Crexont contains extended-release pellets, its absorption is prolonged. Your doctor must carefully calculate any adjustments to prevent major daytime or nighttime “off” periods.
🍔 2. The Link Between Crexont and “Intense Cravings”
An intense, physical craving for food—rather than weakness or shaking—strongly points toward a dopamine-driven compulsive behavior.
- Impulse Control Alterations: Levodopa medications stimulate the brain’s reward pathways. In some individuals, this triggers unusual or compulsive behaviors, such as binge eating or intense late-night food cravings (often for sweets or carbs).
- Not True Hunger: Because it is a chemical craving rather than a metabolic need, eating more during the day rarely stops this specific feeling.
📋 3. Next Steps and Doctor Discussion Guide
Keep taking your 7:00 p.m. dose exactly as prescribed for your safety until you can consult your movement disorder specialist. When you speak with them, use these talking points:
- “I am experiencing intense, physical food cravings at night that feel more like a compulsive urge than hunger. Could this be an impulse-control side effect of my Crexont?”
- “My insomnia is highly disruptive. If we alter or reduce my 7:00 p.m. Crexont dose, how will we prevent overnight stiffness and ‘off’ time?”
- “Would a different medication timing or a lower evening dose coupled with strict behavioral boundaries help manage these cravings?”
Would you like me to draft an email or a portal message that you can send directly to your neurologist to explain these symptoms?
No, thank you. You’ve been very helpful. And actually, a few weeks ago I met with the doctor who is overseeing my DBS response, and during the visit we spoke about how it would be OK for me to stop the Crexont at 7:00 p.m. But thank you again; you’ve been very helpful.
