Addressing Constipation, Sleep, and Fatigue in Parkinson Disease Care: Alexa Dessy, MD

WATCH TIME: 4 minutes

"These conversations can sometimes take up more of the visit than medication adjustments, but they’re crucial for improving overall quality of life in Parkinson disease."

Patients with Parkinson disease (PD) face a mix of motor and nonmotor symptoms that evolve over time. Motor symptoms typically include rest tremor, muscle rigidity, bradykinesia (slowed movements), and postural instability, all of which can make walking, balance, and everyday tasks increasingly challenging. As the disease progresses, many also experience freezing of gait, reduced facial expression, softer speech, and fluctuations in movement control, sometimes complicated by involuntary movements from long-term medication use.

Equally impactful are PD’s nonmotor symptoms, which can appear years before motor changes. To understand more about the importance of treating secondary symptoms of PD, NeurologyLive^® reached out to Alexa Dessy, MD, a clinical assistant professor in movement disorders at Jefferson Health, with several years of treatment experience. Dessy, who studied at NYU School of Medicine, discussed the importance of addressing nonmotor symptoms in PD–such as constipation, apathy, fatigue, and sleep issues–that can have as much impact on quality of life as motor fluctuations.

In the interview, Dessy highlighted the role of lifestyle interventions and nonpharmacologic management as first-line strategies, particularly personalized exercise routines and behavior changes tailored to each patient’s interests and abilities. Dessy also discussed the need for thorough evaluation to identify root causes of issues like sleep disruption and to involve multidisciplinary support when needed, noting these discussions often take as much time as motor symptom management during clinic visits.