SHINE A LIGHT ON BETTER SLEEP

QA family member suffers continual debilitating insomnia due to Parkinson’s disease and I have read that bright light therapy could help. Could you confirm this and advise on how to use it?

AParkinson’s disease is a progressive neurological condition that affects one in 500 people, mainly aged 55 and older. Sleep problems occur in up to 96 per cent of patients, according to consultant neurologist Professor K Ray Chaudhuri of King’s College Hospital, adviser to Parkinson’s UK (parkinsons.org.uk).

‘Bright light therapy can really help some patients,’ says Professor Chaudhuri. ‘However, sleep disorder associated with Parkinson’s is complex and includes a range of problems, so it is important to define the specific type.’ In 2002, Professor Chaudhuri and colleagues developed the Parkinson’s Disease Sleep Scale (PDSS) for doctors to evaluate the frequency and specific nature of individual patient’s problems to help treat them. (Search PDSS on parkinsons.org.uk to download it.)

Types of sleep disruption include difficulty getting to sleep (onset insomnia), staying asleep (maintenance insomnia), bad dreams, behavioural issues such as acting out violent dreams (known as REM sleep behaviour disorder), problems turning over, needing to urinate often (nocturia), frequent stiffness, spasms, low mood or depression on waking. ‘On top of that is restless leg syndrome and sleep apnoea [breathing problems],’ says Professor Chaudhuri. ‘These can all cause daytime drowsiness and other symptoms such as memory problems and lower immunity to infection.’

You say that your family member mostly has problems staying asleep and bright light therapy, which is not an invasive treatment, may help this, according to Professor Chaudhuri. He advises 30 to 60 minutes first thing in the morning.

You can find light therapy panels online, usually advertised for treating seasonal affective disorder. They emit summer levels of bright light, with a usual output of 10,000 lux at a distance of 25cm. Professor Chaudhuri prefers 7,500 lux so it might be wise to sit a little further away (and always avoid looking straight at the light source). One option is the Lumie Arabica light box (£99.95, lumie.com).

Additionally, Professor Chaudhuri advises taking supplementary vitamin D year-round as a deficiency, which triples the risk of developing osteoporosis, particularly in older women, is common in Parkinson’s. Talking to your doctor about a bone density scan and testing for vitamin D levels is vital.

QMy daughter, aged eight, suffers from inflammation round the outside of her vagina, which is not responding to the doctor’s treatment for thrush.

AThe irritation may be a reaction to ingredients in cleansing body products, including bubble bath and gel wash. Pharmacist Shabir Daya recommends trying Salcura Bioskin Junior products, which use natural oils to soothe sore inflamed skin and include Face & Body Wash (£8.99), Bath Milk (£9.99) and a topical Outbreak Rescue Cream (£9.99, all victoriahealth.com).