Huntington’s disease and sleep

Last updated Feb. 10, 2025, by Agata Boxe
Fact-checked by Patrícia Silva, PhD

Huntington’s disease can interfere with your sleep, keeping you up at night. Chronic Huntington’s disease sleep issues can worsen cognitive, behavioral, and emotional changes caused by the condition.

A good night’s rest plays a key role in managing Huntington’s and may help to slow disease progression.

Finding ways to try to sleep better is important for your overall well-being. This can involve making changes to your bedroom, practicing relaxation techniques, and doing your best to manage the emotional aspects of living with Huntington’s disease.

How Huntington’s disease affects sleep

Living with Huntington’s can affect the way your brain works and disrupt your sleep, making it challenging to get quality rest.

Sleep complications with Huntington’s are more likely to appear as the disease progresses.

Huntington’s symptoms such as involuntary movements at night can wake you up or make it harder to fall asleep. Potential mental health challenges linked to the disease can also contribute to sleep problems.

Poor sleep may leave you feeling exhausted, agitated, and anxious the next day. You may have a constant urge to doze off.

The connection between Huntington’s disease and sleep may be related to the progressive damage and loss of brain cells the disease causes — a process that ultimately affects the brain regions involved in controlling sleep cycles.

A full sleep cycle lasts between 90 and 120 minutes, or 1.5 to two hours, and involves different stages, from the initial stage where your mind drifts off to the deepest layers of slumber. Completing four to six sleep cycles, and successfully phasing through all the stages in each, is necessary to wake up feeling truly rested and restored.

Huntington’s can also affect the body’s circadian rhythm, which is your internal clock that tells your body when it is time to sleep and when to wake up. Such disruptions can also make it difficult to get a good night’s rest.

Huntington’s disease symptoms, such as chorea and other involuntary movements, and tiredness, as well as anxiety and depression — not uncommon in people with Huntington’s — can further impact sleep quality.

The reverse can also be true: Poor sleep may result in you feeling exhausted, anxious, or depressed, especially if it becomes chronic.

Common sleep issues for people with Huntington’s

Huntington’s sleep issues can affect you in many ways, such as by keeping you up at night or making you feel like you need to nap a lot during the day. Other sleep conditions can cause you to snore or move around excessively in bed.

Let your doctor know about Huntington’s disease sleep disturbances because such problems can worsen fatigue and other symptoms as well as increase the impact of the disease on your cognition and mental health.

One of the most common sleep issues in Huntington’s is insomnia, which makes it difficult to fall or stay asleep. Insomnia may be temporary or chronic, and leave you exhausted and irritable.

Another nighttime disruption related to the disease is sleep apnea, in which your breathing stops and starts repeatedly during sleep. It interrupts breathing during sleep, may cause snoring, and prevents you from getting a good rest. Sleep apnea may also be another reason you are tired during the day.

Excessive daytime sleepiness (EDS) can cause you to struggle to stay awake or be alert during the day even after you’ve had many hours of sleep.

The link between Huntington’s disease and excessive sleeping during the day can also be caused by some Huntington’s disease treatment medications, such as those targeting chorea.

Sleep-related movement disorders involve unusual or repetitive movements that often interfere with falling or staying asleep.

REM sleep behavior disorder (RBD) can cause you to act out your dreams while you are sleeping. With RBD, you may violently flail your arms and legs while talking, laughing, or shouting.

Tips to improve sleep hygiene

While ending your evening with a good movie or a book can be a good way to relax and not think about your Huntington’s disease sleep issues, it can also tempt you to delay going to sleep. Try to not give in: Sticking to the same bedtime and following other so-called sleep hygiene rules can benefit your long-term sleep quality.

Establish a supportive nighttime routine by:

• going to bed and getting up at the same time every day, including weekends
• avoiding bedtime procrastination, or a tendency to delay going to sleep
• trying mindfulness meditation to clear your mind of daily worries
• relaxing with deep breathing by slowly breathing in through your nose and slowly exhaling through your mouth.

Try to resist catnapping during the day, which makes it more likely that you’ll have a restless night. If you have to nap, set an alarm and limit it to no more than 30 minutes.

Make your bedroom feel safe and comfortable, and optimized for sleep.

• Light tends to keep the body awake and can disrupt sleep, so keep your bedroom dark at night, such as by installing blackout blinds or curtains.
• Buy bedding and sheets that help regulate body temperature, especially if you feel too cold or too warm at night.
• Protect your skin by getting a mattress that helps relieve putting pressure on it, which can be an issue, especially in the later disease stages of Huntington’s.
• Choose a bed that is wider and lower to minimize the risk of falling out of bed from involuntary movements that can occur while sleeping or when getting up.
• Add a bedside rail or use a weighted blanket to help keep you from rolling onto the floor.
• Use motion-detecting nightlights to help you safely make your way to the bathroom in the dark.
• Meet with an occupational therapist to get tips for setting up your bedroom for better sleep.

Treatment options

If you are dealing with persistent sleep problems, talk to your healthcare team. They can recommend how to address it. Options may include medications, talk therapy, and assistive devices.

Depending on your exact sleep issue, you may be prescribed medications or supplements, such as melatonin for insomnia. However, you should not try to self-medicate with melatonin or any other supplements, because they can interfere with your Huntington’s medications and have other unintended effects. Only your doctor will know whether a supplement may be appropriate for your symptoms and, if so, at what dosage. Your physician can also talk with you about what kind of supplements may be right for you.

A doctor on your team may recommend cognitive behavioral therapy, known as CBT, for insomnia.

CBT can help you with any anxiety you may have about sleep, as well as help you create and stick to a routine conducive to slumber. The American Academy of Sleep Medicine recommends CBT as a first-line therapy for chronic problems falling or staying asleep in the general population.

For sleep apnea, your doctor may suggest a continuous positive airway pressure or CPAP machine that delivers air to support breathing during sleep.

How caregivers can assist with sleep

Caregivers are often attuned to the issues affecting their loved ones with Huntington’s disease, including those involving sleep. If you are caring for someone with the condition, you may be able to help your loved one manage sleep problems.

How caregivers can offer support:

• Consider keeping a sleep journal for the person you are caring for, to record patterns and observe triggers.
• Communicate any issues and observations from the journal to the doctor or healthcare team the person you’re caring for is seeing.
• Make sure your loved one is following any sleep recommendations from doctors.
• Gently remind the person you’re caring for about the importance of maintaining a good sleep routine.
• Offer to do some of the routine with your loved one, for example, by meditating together.

Lifestyle adjustments that may improve sleep

Sleep issues with Huntington’s can be especially severe and challenging, and often require lifestyle changes. A holistic approach can make a long-term impact on your ability to rest well, and may include diet, exercise if possible, and ways to manage stress. Some strategies may help you feel better overall:

• Limit or eliminate alcohol and caffeine, especially close to bedtime.
• Stay away from heavy or spicy foods at dinner if heartburn is an issue.
• Try to stop getting up frequently in the middle of the night to use the bathroom by not drinking too much liquid in the evening.

While exercising with Huntington’s can be challenging, it can promote sleep.

Talk to your doctor and consult a physical therapist to find a type of exercise that may be right for you.

Walking, with the use of a mobility aid if needed, stretching, and strength training — which can also be done while sitting — are some of the potential options for the early to middle-late stages of Huntington’s disease.

The stress of living with Huntington’s can also impact sleep. Discomfort from symptoms and worry about the future can disrupt your peace of mind, keeping you awake.

Because dealing with stress with Huntington’s can be overwhelming; you may want to consider talking to a therapist. Look for someone who has treated people with chronic diseases or has one themselves. You can ask your doctor for a referral or reach out to Huntington’s disease support groups for recommendations.

Joining a support group — in person or online — can also be a source of emotional comfort. Huntington’s Disease News has a Facebook page, and the Huntington’s Disease Society of America offers a listing of support groups.

Finally, fun hobbies — such as reading, painting, or playing board games — can be relaxing and restorative, promoting better sleep.

Huntington’s Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.