Turning in Bed With Parkinson's: 7 Techniques for Easier Nights

Why is turning in bed so hard with Parkinson's, and what helps? Parkinson's makes movements slower, smaller and stiffer, and medication can wear off overnight, so rolling over can feel like a big effort. Breaking the movement into simple steps, using your knees and arms to lead, and setting up the bed well can make turning in bed with Parkinson's much easier for many people.

This guide is for people with Parkinson's, and for partners and carers whose nights are disturbed too. It covers night-time bed mobility only. For tremor, freezing and getting around during the day, see our guide to Parkinson's physiotherapy at home.

Why turning in bed is hard with Parkinson's

The NHS describes the main movement symptoms of Parkinson's as tremor, slowness of movement and muscle stiffness. In bed, these can combine in frustrating ways:

• Slower, smaller movements. Parkinson's can shrink movements without you noticing. A roll that needs one big push may come out as a small shuffle that doesn't get you over.
• Stiffness. Rigidity (stiffness in the muscles) makes it harder to twist your trunk and hips.
• Medication wearing off. Many people find symptoms are worse at night or first thing in the morning, when their medication is wearing off (often called an "off" period). Parkinson's UK explains how Parkinson's symptoms can affect sleep. If this sounds familiar, talk to your Parkinson's nurse, specialist or GP about the timing or type of your medication. Never change your medicines yourself.
• Friction from bedding. Heavy duvets, tucked-in sheets and brushed cotton pyjamas can grip, so you have to fight the bedding as well as your body.
• Tiredness on both sides. Poor nights for the person with Parkinson's often mean poor nights for their partner too.

7 techniques for turning in bed with Parkinson's

These steps describe rolling onto your right side. Swap left and right to roll the other way.

1. Break the roll into steps

Parkinson's makes automatic movements harder, but planned movements often work better. Instead of trying to "just turn over", think of it as a short list of separate moves.

Try this: Learn this order: bend your knees, drop them to the right, reach your left arm across, then roll your shoulders. Say each step in your head (or out loud) before you do it.

2. Bend your knees and let them swing over

Your legs are heavy, and that weight can help you turn. With your knees bent and feet flat, your legs act like a lever. When they drop to one side, your hips follow, and the rest of your body finds it easier to come round.

Try this: Lying on your back, bend both knees and slide your feet up towards your bottom. Then let both knees fall together towards the right side of the bed.

3. Reach across and roll with your arm

Your head and arm can lead your upper body round. Turning your head to look where you are going starts the movement. Reaching your top arm across your body pulls your shoulders over to meet your hips.

Try this: Turn your head to look to the right. Then reach your left arm across your body towards the right edge of the bed (or a bed lever, if you have one) and let your shoulders follow.

4. Make big, deliberate movements with a cue word

Thinking "big" helps counter the way Parkinson's shrinks movements. A cue (a word, count or sound that prompts a movement) can help start a movement that feels stuck.

Try this: Pick one cue word, such as "Big!" or "Roll!", or count "one, two, three, turn". Use the same cue every time, and make each movement larger than feels natural.

5. Try satin sheets or a slide sheet, carefully

Smooth fabrics reduce friction so you can turn with less effort. Parkinson's UK's sleep and night-time problems booklet suggests satin sheets or satin pyjamas may help, but not both together, as that can make you slide out of bed too quickly. It also advises keeping an area with some grip at the end or sides of the bed. A slide sheet (a slippery fabric sheet used for moving in bed) can also help, but it is best used with advice from a therapist.

Try this: Try a satin panel across the middle of the bed only, so the edge where you sit to get out still has grip. Never stand up on a slippery sheet or in satin pyjamas on a smooth floor.

6. Use a bed lever or rail, and check the bed height

Something firm to hold gives you a handle to pull and push against. A bed lever (a handle that fits under the mattress beside you) or a bed rail can make turning and sitting up easier. Bed height matters too. When you sit on the edge, your feet should rest flat on the floor with your knees at about the same height as your hips. Bed rails and levers must be the right type for your bed and fitted correctly, as gaps can trap arms, legs or heads.

Try this: Ask your GP, Parkinson's nurse or local council for an occupational therapy assessment (an occupational therapist helps people manage everyday tasks and can advise on equipment).

7. Follow the getting-out-of-bed sequence

Getting out of bed with Parkinson's is easier as a set of steps than as one big effort. Sitting straight up from lying flat is hard work. Rolling first and using your arms to push up spreads the work out.

Try this: Practise this sequence in the daytime first:

1. Roll onto your side, close to the edge of the bed, using techniques 1 to 4.
2. Legs over. Slide your feet and lower legs over the edge.
3. Push up. Push down through your bottom elbow, then your hand, as your legs lower towards the floor. Your body will come up to sitting.
4. Sit and pause. Sit on the edge with your feet flat on the floor and count slowly to ten before you try to stand.

Getting up at night safely

Night-time trips to the toilet need extra care. A few changes can make them safer:

• Lighting. Keep a lamp or touch light within easy reach, and use plug-in night lights along the route. Turn it on before you get up.
• A clear route. Move rugs, shoes, cables and clutter away from the path between the bed and the toilet. If the trip is long or you need to go often, ask about a commode or urine bottle by the bed.
• Sit before you stand. Some people feel dizzy when they stand, which can be linked to a drop in blood pressure. Pausing on the edge of the bed helps. Our guide to dehydration, blood pressure and falls explains more.
• Stand, then go. Once standing, wait a moment and make sure you feel steady before you walk.
• Keep a way to call for help. Keep a phone within reach of the bed, or wear a personal alarm if you have one.

What to do if someone gets stuck or falls

If they get stuck in bed

1. Stay calm and speak slowly. Rushing usually makes things harder.
2. Don't pull on their arms or lift them. This can injure you both.
3. Talk them through the steps. Use the same cue word and steps as above, one at a time.
4. Make them comfortable if it isn't working. If they are in an "off" period, it may be easier to adjust pillows and covers and try again a little later. Follow any advice their Parkinson's nurse has given.

If they fall

Don't rush to pull them up. Check for injury first. Our guide to how to get up safely after a fall explains the steps, and when to stay put and wait for help.

Call 999 if they:

• are badly hurt, bleeding heavily or can't move a limb normally
• have hit their head and are drowsy, confused or being sick
• are unconscious, have chest pain or are struggling to breathe
• can't get up and you can't help them up safely

Call NHS 111, or contact their Parkinson's nurse or GP, if:

• they have fallen but don't seem hurt, and you're not sure what to do next
• their symptoms are suddenly much worse, or they are newly confused or seeing things
• they have a high temperature or seem generally unwell, as illness can make Parkinson's symptoms worse for a while
• night-time problems or falls keep happening

Looking after someone at night is exhausting. Our guide to caring for a loved one at home has ideas to help you protect your back and get some rest.

When physiotherapy helps

A neurological physiotherapist (a physio who specialises in conditions of the brain and nerves) can help if:

• turning or getting out of bed is taking longer or needs more help
• you or your partner are losing sleep because of it
• there has been a fall or a near miss at night
• you're not sure which techniques or equipment are right for you

Bed mobility is best practised in your own bed. At Rehalign, our neuro physiotherapists offer home visits across the West Midlands, including Birmingham, Solihull, Walsall, Wolverhampton, Coventry, Dudley and Telford. We can practise the steps with you and your partner.

Book a neuro rehab assessment