yoga for a better night’s sleep in Parkinson’s – part I

Sleep is a common difficulty in Parkinson’s disease (PD).

People with PD not only have difficulty falling asleep at night, they have difficulty staying asleep, and experience daytime sleepiness. Also, people with PD commonly are diagnosed with restless leg syndrome, rapid eye movement behaviour, and may experience nightmares or nightime delusion (often as a result of medication)… all of which can also be very disruptive to their bed-partners sleep! However, the link between PD and sleep disorders has yet to be clarified.

We also know that PD can impact “working memory”, so things like planning and problem solving required for everyday living. A new study now shows that sleep issues associated with PD can also impact working memory, making day-to-day living a cognitive challenging in sleep-deprived people with PD!

Specifically, “slow wave sleep” or the deepest part of sleep, is important for brain plasticity (cells make new connections). Having a full’s nights sleep saw significant improvements in working memory, especially in people taking dopamine medication.

… so what does this mean? Addressing sleep disorders in PD can potentially improve working memory capacity in patients with PD.

… and do you know what helps with sleep? YOGA!

After 6months of regular practice, yoga can significantly decreased the time taken to fall asleep, increases number of hours slept, and increases feelings of being rested in the morning compared to non-yoga controls in an older adult population (Manjunath & Telles, 2004).

stay tuned (next post!) for some wonderfully relaxing and restorative poses that you can do right in your bed for a better nights sleep… just like Levon! much love.

sleeping bulldog

P.S. Want more info on sleep in PD? References: Michael J Fox Foundation’s FoxFeedNocturnal sleep enhances working memory training in Parkinson’s disease but not Lewy body dementia (Brain, 2012); Sleep and Parkinson’s disease (Mov Disord, In Press).

yoga for depression in Parkinson’s – a follow up…

I wanted to follow up on my introduction to depression and how it shows up in PD HERE and some yoga poses to help open the heart and calm the mind HERE

The National Parkinson Foundation (NPF) released (today!!) early findings from the largest clinical study of Parkinson’s disease ever conducted (“Parkinson’s Outcomes Project”), showing that depression is the most important factor influencing the health status of Parkinson’s patients.

Recommendations from this project on how to address depression and positively impact health and well-being are as follows…

  • Physicians screen patients for depression at least once a year.
  • Patients discuss any change in mood with a healthcare professional, and make sure that their Parkinson’s doctor is aware.
  • Patients bring to doctor’s appointments a family member who is encouraged to share any changes noted in the patient’s mood.

For more information, check out the media release from the National Parkinson Foundation HERE or download the Parkinson’s Outcome Project report HERE.

What timely and important information! much love.


from research to real life – brain injury and Parkinson’s

Recently, there has been lots of talk about head injuries and neurodegenerative diseases…

In September 2012, a study was published stating professional football players at 3 times more likely to develop neurodegenerative diseases than the general population (from CNN). 3 players from the 334 included in this study were diagnosed with Parkinson’s disease, though this was not significantly different than the average population. The NFL took action by donating $30mil to National Institute of Health for brain injury research (link HERE!).

NFL hall of famer Forrest Gregg reveals battle with Parkinson’s disease
(Mark Lyons, Getty Images Sport)

… In other football news, the longest serving member of the Edmonton Eskimos, Dwayne Mandrusiak – who has been their equipment manager for 42 seasons (!!) announced he was diagnosed with Parkinson’s in August. The following link shares his story of how he was diagnosed (approached by team physicians), who he is leaning on for support, his symptoms right now (rigidity) and how he is determined to not let PD stop him!  Check out the inspiring read HERE!

Dwayne Mandrusiak, equipment manager for the Edmonton Eskimos, diagnosed with PD Aug 2012 (

I thought I would mention (see previous info here!) about some of the latest Parkinson’s research…

The main idea: Participants with PD were twice as likely as those without PD to report having had a head injury in which they lost consciousness for more than five minutes. This risk was increased if the participant was exposed to paraquat (i.e. live <500m). The trauma from the brain injury may leave brain cells more vulnerable to the exposure of other environmental toxins – creating more damage (i.e. combination of multiple risk factors)

Research: Tramatic Brain Injury, Paraquat Exposure and their Relationship to Parkinson’s disease (Neurology, 2012)


and remember, safe is sexy!…. wear a helmet. much love.

P.S. interested in occupation and risk for Parkinson’s? Read more HERE!

Tutorial – yoga for depression in Parkinson’s – part 2

I wanted to following up with my introduction to depression in Parkinson’s disease and the benefits of yoga (hello, Breath of Joy!). In this TUTORIAL (new regular post!) are 3 yoga poses that I find are constructive ways to release tension, improve mood and find balance.

1. Gentle BackBends or Heart Openers

Here, I want to offer 2 suggestions…

1.A. Fish Pose (Matsyasana)

Benefits: Releases tension and is also good for deep breathing and relaxation. This is a great chest-opener; many people who have depression coupled with anxiety often have feelings of tightness or pressure in the chest—this pose can help ease the pressure. The Fish is also very beneficial for a tense neck, shoulders and lower back.

Contraindications: Back pain, injuries to neck or shoulder

  • Lie flat on your back with your knees straight and keep your feet together with toes pointed to the ceiling.
  • Slide your hands under your thighs and buttocks. This motion should cause your chest to bow upward slightly.
  • Bend the elbows and push them into the floor; use the bend of the elbows and arms to raise the chest higher, keeping the chest arched upward.
  • When the chest is arched as high as possible, drop your head and rest the very top of your head on the floor. Your chin should point to the ceiling.
  • While in this posture, breathe deeply and really enjoy the chest expansion. Hold this position for as long as is comfortable.

OR 1.B. Bridge Pose (Setu Bandhasana)

Benefits: Back bends may benefit those with depression. Bridge Pose, can be stimulating and fight darkness and delusion.


  • Lie on the floor and place a thickly folded blanket under your shoulders to protect your neck. Bend your knees.
  • Exhale while pressing your inner feet and arms down, then push your tailbone upward, lifting the buttocks off the floor. Keep your thighs and inner feet in line and make sure your knees are directly over your heels.
  • You may progress to clasping your hands below your pelvis and extend through your arms to help you stay on the tops of your shoulders.
  • Elongate the tailbone toward the backs of the knees and lift the pubis in the direction of the navel. Push the top of the sternum toward the chin.
  • Release with an exhalation, rolling the spine gradually down onto the floor.

2. Child’s Pose (Balasana) – see full post HERE

Benefits: A good, relaxing counter-pose when performed after Fish. Child’s pose is comforting and peaceful. It enables connection of the third eye to the earth and promotes safety and security. It also stretches lower back and shoulders … which feels wonderful!

Contraindications: Back injury.

  • Kneel on the floor, and then sit onto your heels.
  • Open your knees until they are a little more than hip-width apart (giving space for your chest to come down between your thighs).
  • Bend forward at the hip; bring your chest to rest between your thighs.
  • Try and keep your buttocks in contact with your heels (if this is not happening either: A. widen your knees OR B. place a cushion between your hamstrings and buttocks). Also, rest your forehead either on the floor OR on a cushion/folded blanket OR stacked fists.
  • Lengthen your arms out in front of you on either side of your head. You can also slide your arms back to your sides, palms up and relax.

3. Legs up the Wall Pose (viparita karani)

Benefits: This pose is great to calm the mind, and I find it especially relaxing before bed! It’s great to relieve tired or cramped legs and feet. It also relieves mild backaches.

Contraindications: Back injury or glaucoma. *Note: If your feet begin to tingle during this pose, bend your knees, touch your soles together, and slide the outer edges of your feet down the wall, bringing your heels close to your pelvis.

*Note: you can also place your legs on a chair if this creates too much tension on your back or you have difficulty getting into this version of the posture – see HERE

  • Start with a cushion/rolled up blanked about 5 to 6 inches away from the wall. Sit sideways on one end of the support (with your side against the wall) (see pic 3.(prep)) and swing your legs up onto the wall and lean your shoulders and head lightly down onto the floor *this may take a few attempts … Your sitting bones should be “dripping” down into the space between the support and the wall and your lower back should be supported by the cushion/blanket (see pic 3.)
  • Elongate the back of your neck and soften your throat *here you can place a small rolled towel under your neck if the cervical spine feels flat. Open your shoulder blades away from the spine and stretch your arms out to your sides, palms up.
  • Keep your legs firm enough to hold them vertically in place.
  • To release, slide off the support onto the floor before turning to the side. You can also bend your knees and push your feet against the wall to lift your pelvis off the support. Then slide the support to one side, lower your pelvis to the floor, and turn to the side.

And most importantly – savasana!

Try these poses to create an open heart and relaxed body and mind! much love.

coping skills for parkinson’s care partners – PDF expert briefing

I attended an online presentation from the Parkinson Disease Foundation on coping skills for PD caregivers, in honour of National Family Caregivers Month.

my grampy, who had PD, and his loving wife and eventual caregiver (1991).

my grampy and his formal caregivers at the care home.

Dr. Julie Carter, from the Parkinson Centre of Oregon, spoke about how caregivers are integral to the emotional and physical health of the persons with PD.

She spoke on how stress impacts the mind-body and introduced a concept called the “self care toolbox”.

1. Stress affects the mind-body

Due to stress, caregivers have chronically elevated levels of cortisol, which can be toxic to your cells!

Also, with increased stress, our telomeres (protective caps of DNA/chromosomes) get shorter! This is related to rapid aging and shorter life expectance.

This makes stress-managment important! But first, we need to recognize the signs of stress…

  • exhaustion
  • anger
  • depression
  • frustration
  • resentfulness
  • irritability
  • sadness
  • loneliness
  • sleep deprivation
  • panic attacks
  • anxious
  • colds, ulcers and other physical complaints

What to do? Tracking these signs of stress and noting the surrounding environment and situation when you feel the sign can help identify triggers/patterns of stress.

2. Self-care toolbox

The following are 7 skills that can help caregivers care for themselves and thus better care for their loved one

  • Self-compassion. Caregiving jobs are one of the hardest, so don’t be hard on yourself! Find support, be non-judgmental and know you are not alone.
  • Connections. Make good social networks that help you problem solve (support groups, family, friends, formal support). Learn to ASK for help – most people want to help you but don’t know how. Take advantage of formal support.
  • Communication. Express your emotions (through journaling, art, counselling, conversation) so you can communicate more effectively and meaningfully with your spouse. *Note: PD changes communication (i.e. lack of facial expression, quiet voice, slow response time, lack of spontaneous gestures), so you need to be more present and engaged.
  • Optimism. Change the patterns of automatic negative emotions/behaviours/beliefs. You can change the situation but you can change how you feel about it and behave.
  • Flexible/creative problem solving. Identify a problem and come up with a variety of ways to deal with it… try something new and be willing to try again!
  • Care for yourself. This is a necessity, not a luxury! Identify pleasurable activities (i.e. morning coffee, walking the dog, exercise with friends) and track how you feel when you are doing this activity… it’s not superfluous if it makes you feel GOOD!
  • Take charge. Focus on what you can control.

If you are interested, you can see the entire presentation here.

And a HUGE thank you to all the caregivers for everything that you do! Happy caring and much love.

P.S. want more caregiver care? See HERE , HERE and HERE.

yoga for depression in Parkinson’s – part 1

Depression is common in Parkinson’s disease, but is not easily distinguished.

The implications of depression in someone with PD and their caregiver(s) can be as grave as physical symptoms, especially since there is a reluctance to admit you are suffering from depression.
In Parkinson’s, depression is less about guilt and self-reproach, but is more focused on the symptoms of irritability, anxiety, sadness, and concern with health. Especially in later stages of the disease, it can be difficult to identify depression among the progressing symptoms (see chart below, Calne 2003).

It is really important to support depression in Parkinson’s by having an advocate, who can speak up about the symptoms if the persons with Parkinson’s and/or caregiver does not feel comfortable. An advocate can help get appropriate counsel, treatment and provide positive reinforcement for both person with Parkinson’s and caregivers.
The practice of yoga can help manage depression. Specially, LifeForce Yoga for depression is a yoga practice that is intentionally designed to work with and manage mood. Amy Weintraub is the founding director of LifeForce Yoga and author of Yoga for Depression. She recovered from her own battle with depression through her meditation and yoga practice. She is also part of the Kripalu family!
Breath of Joy! is one of my favourite ways to get my body moving and bring some joy into my day… and the best part about it is that it is so accessible to anyone! You just need to move with your breath… and feel the love!
P.S. for a more detailed description of Breath of Joy see HERE
Here’s a great video demo by Amy Weintraub
 So, take a moment each day and lean toward joy!  expand your heart, and your capacity to nourish yourself. Identifying signs of depression in Parkinson’s early gives you the best chance to seek the care you need… and yoga is a wonderful tool to help you feel the joy! much love.

my favourite things – parkinson’s novels

1. The imaginative, hilarious, and moving memoir of a 43-year old woman coping with both Parkinson’s disease and breast cancer. With irreverent and at times mordant humour, Most of Me chronicles Levy’s early, mysterious symptoms of Parkinson’s (a dragging left foot, a frozen left hand, and a crash into “downward dead dog” position on the yoga mat), and her life dealing with her diverse disease portfolio. Both heartbreaking and hilarious, Most of Me offers a unique glimpse into a creative mind and the restorative power of humour and fantasy (adapted from CBC books). You can check out my previous review HERE! and her wonderful blog HERE!

2. Combining his trademark ironic sensibility and keen sense of the absurd, he recounts his life — from his childhood in a small town in western Canada to his meteoric rise in film and television which made him a worldwide celebrity. Most importantly however, he writes of the last 10 years, during which — with the unswerving support of his wife, family, and friends — he has dealt with his illness. He talks about what Parkinson’s has given him: the chance to appreciate a wonderful life and career, and the opportunity to help search for a cure and spread public awareness of the disease (adapted from Please check out the Michael J Fox Foundation to see how you can get involved!

3. Kondrake writes a deeply personal and bracingly honest account of how he and his wife, Milly, have coped with her diagnosis of Parkinson’s disease. Milly’s passionate enjoyment of life made it very difficult for her, at the age of 47, to accept a doctor’s opinion in 1988 that the tremors she was experiencing were the beginnings of Parkinson’s disease. The Kondrackes finally came to terms with Milly’s condition and began searching for a treatment. Milly underwent several operations and has had various drug therapies, but her condition continues to worsen. She is now dependent on others for physical care and can barely communicate. Kondracke provides a harrowing overview of how organizations for other diseases such as AIDS or breast cancer compete with Parkinson’s advocates for badly needed research dollars (adapted from publishers weekly). You can check out my previous review HERE!

4. Inspired by her father’s (boxer Muhammad Ali) interaction with her children, Rasheda Ali wrote this book to address most commonly asked questions from children who may not understand why their loved ones with Parkinson’s disease behave in certain ways. Written for adults to read to children, the book encourages dialogue through the use of colorful illustrations, situations depicting symptoms, and interactive questions. Medical facts are provided at the end of each page to help readers answer children’s questions with greater ease (adapted from amazon).


keeping my nose in the books!

Awakenings, by Oliver Sacks

The remarkable story of a group of patients who contracted encephalitis lethargica after World War I. The patients were frozen for decades in a trance-like state. The catatonic behavior of the encephalitis patients is similar to that of Parkinson’s patients, so Dr. Sacks (or Sayer in the book, played by Robin Williams in the movie version) investigates the latest advances in Parkinson’s treatments. In 1969, Dr. Sacks/Sayer gave them the then-new drug L-DOPA, which had an astonishing, explosive, “awakening” effect. However, patients who are treated with the drug develop a tolerance for it, and soon his patients return to their former state. Dr. Sacks recounts the moving case histories of his patients, their lives, and the extraordinary transformations which went with their reintroduction to a changed world. I love Robert De Niro’s character Leonard Lowe in the movie version (see the trailer below)!

HAPPY READING! much love

**note: click on number to be taken to where you can purchase these great reads!

from research to real life – caffeine may help Parkinson’s symptoms

How many of us make it a daily ritual of grinding and brewing a cup at home, or swinging by our local coffee spot?

Well, now research is showing that not only are coffee-drinkers less likely to develop Parkinson’s disease, but that caffeine may improve motor symptoms in persons living with Parkinson’s …

The main idea: after giving people with Parkinson’s a caffeine dose (equal to 3 cups of coffee a day), significant improvements in motor symptoms (UPDRS motor score) were seen compared to those given placebos. It is thought that caffeine may block a brain receptor (adenosine A2 “antagonist”) and improve dopamine transmission.

Research : Caffeine for Treatment of Parkinson’s disease: an RCT (Neurology)

Real life : Caffeine May Help Ease Parkinson’s Symptoms (The Globe and Mail)

However, results should be interpreted with caution as the sample was small, trial was of short duration, and it’s hard to blind participants who received caffeine and who received placebo (hello, caffeine withdrawal headache!).

Well, cheers to that research! much love.

P.S. like coffee? check these out; the caffeinator, coffee and risk for PD, michael j fox foundation

my favourite things – yoga for surfing

We are heading up to Tofino to celebrate the long weekend (and my 29th birthday!), so I thought I’d share some of my favourite things about surfing…

Since moving to Vancouver Island, we’ve been giving surfing a try.

Our first surfing experience was in Lagos, Portugal during one of our European adventures when Darc was living in Germany.

Lagos, Portugal (April, 2008)

After that, we made the 10-HOUR trek from Kelowna to Tofino for a weekend surf trip.

Keeping warm in Tofino, BC (November, 2010)

Me and my softop in Tofino, BC (November, 2010)

Now that we are living on the island , we’ve been gearing up and catching some waves (errr, well whitewash for me anyways).

wetsuits and a salty-bulldog in SUNNY (!!) Tofino (Aug 2012)

Now, the North Pacific is COLD andWET (hello! rainforest!), but, that doesn’t mean it can’t be fun! If you’re going to get wet anyways, you might as well do it in a 6mm wetsuit with a hood, gloves and booties!

YOGA is another great way to get ready for a surf weekend. Here are some of my favourite surfing-related yoga poses…

  1. Garudasana (Eagle Pose). To stretch out your upper back and shoulders for a big day of paddling!
  2. Chaturanga (Four-limb Staff Pose). For everything! Your pop-ups will improve like nobody’s business!
  3. Shalabhasana (Locust Pose). To strengthen back, abdominals, and to help look up while paddling out!
  4. Malasana (Garland Pose). To open hip flexors and lower back for long sessions of sitting on your board waiting for the perfect waves!

*You can sequence these together, for example: 1) start with eagle on each side, holding for 5-6 breaths. 2) step out and fold forward, (bend your knees to keep your back long!). 3) ground the palms of your hand on either side of your feet and step/jump back into high plank pose (knees down is great for building core and upper body strength!). 4) slowly lower to staff pose – hover (don’t collapse!) about 1inch off the floor. hold for 5-6 breaths. 5) lower to the ground. 6) placing chin on the mat and arms along the side of your body, lift legs into locust (one at at time is great for building strength!). 6) push through hands and knees and come up to standing. place feet mat-width apart (place heels on a rolled up towel if necessary!) and drop down in garland. hold for 5-6 breaths.

So get out there and stretch out before you wax up! much love.

P.S. like surfing? check out what I’ve been up to, and island living

Parkinson Wellness Recovery – Exercise 4 Brain Change!

Last week, I went to a talk by Becky Farley, PhD, MS, PT, sponsored by Parkinson Society BC. The topic was “EXERCISE AS MEDICINE” and she discussed some of the work she does at her Parkinson Wellness Recovery gym in Tuscon, Arizona.

About Dr. Becky Farley

Becky became involved in Parkinson’s disease during her post-doctoral work when she investigated the muscle activation deficits underlying bradykinesia in people with PD. She developed the LSVT® BIG exercise approach and standardized training to targets the PD symptoms of slow/small movements bradykinesia/hypokinesia.

About PWR!

The aim of Becky’s program is to use exercise as a physiological tool to optimize brain function (i.e. neuroplasticity) and health. Her program is based on: early intervention, continuous access and research-based exercise programs. PWR! also trains clinicians and fitness professional with techniques to focus on PD-specific exercise.

Her exercise tips:

  1. “start from a position of power!”. Your body needs to be ready, your brain needs to be focused and the task needs to feel important (or fun!) for change to occur. Make your exercise engaging!
  2. Use equipment (i.e. bungees, ropes, balance boards, harnesses) to get the experience of the full movement safely (especially in people with PD who have difficulty balancing etc.), then start to take some of those supports away as you progress and apply that experience to everyday movements!
  3. For people with PD, especially those with dyskinesias – seek exercises that gain core stability
  4. Sensory feedback – i.e. pacing, metronome, music – can help push you to exercise faster, harder and with more smooth movements
  5. Prime” your body by starting your exercise program with progressive aerobic training, then follow up with skill acquisition-type exercises.
  6. Focus not only on increasing muscle mass, but want to increase useable muscle and focus on functional movements in your exercises… not just “curls for the girls” but include things like:
  • lateral rotations, cross-body, sequential movements, extensions, quick position changes, side-to-side weight shifting)

How does exercise help brain function in Parkinson’s?

Becky also presented some of the latest research on the benefits of exercise on brain function.

Exercise can help increase brain volume, improving working memory and attention. Also, it increases blood vessels and leads to more neurotrophic (growth) factors (like “gatorade” for the brain!) and a more supportive environment for neurons. Exercise also increases the redundancy in brain synapses. Redundancy is good! If you have some synapses that aren’t working, you will have back ups to replace them!

Specifically in PD, research tells us that exercise increases survival rate, increases physical functional ability, and improves cognition! It can help “repair” the dopamine system in early/moderate stages of PD by increasing dopamine D2 receptors and helping your brain make better use of remaining dopamine.

some references of interest:

“How might physical activity benefit patients with Parkinson disease?” Speelman, Nature Reviews, 2011

“Effectiveness of intensive inpatient rehabilitation treatment on disease progression in parkinsonian patients” Giuseppe et al., Neurorehabil Neural Repair, 2012

“Does vigorous exercise have a neuroprotective effect in Parkinson disease?” Ahlskog Je, Neurology, 2011

It was a great talk, and I feel lucky to have been there and met with her. I’m also excited to hear her thoughts on how yoga can fit within this model…

Please check out her PWR website and see if there are any trained-clinician in your area! much love.