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Dear Jennifer, As a registered dietitian, I can't help solve the problems you mention, but I do have some suggestions from my work with my own PD clients. > I wake up somewhere between 2am and 4am stiff, cramped and sore. I am > able to get out of bed ok but shuffle around like a little old lady > until I can take my first dose of Sinemet at 8am. Is your neurologist a movement disorders specialist? This would be the best physician for you to see for PD. I'd discuss your rigidity with him/her for a possible adjustment in type or timing of medications. > Later in the day I usually walk (up > to three miles) or use my exercise machine. Good for you! That's one of the very best things you can do. Weight-bearing and strength exercises are very good at building and maintaining bone mass. This is important to prevent the osteoporosis often seen in people with PD. > Another question is how does one deal with depression? That's an excellent question. Depression is not uncommon in people with PD, and a movement disorders specialist will be aware of this. Don't hesitate or wait to discuss this with your neuro, there are excellent medications available. Please don't continue to suffer silently; instead, speak with your neuro. > Could it be that feeling > tired all the time is causing me to feel lethargic and depressed or > could depression make me feel tired and lethargic and keep me from > sleeping? Your instincts are very good, either the tiredness or the depression or the combination could be at fault. However, fatigue is also common with PD; it's not your fault. Your doctor should be able to address these questions. My very best regards, Kathrynne -- Kathrynne Holden, MS, RD "Nutrition you can live with!" Medical nutrition therapy http://www.nutritionucanlivewith.com/ Tel: 970-493-6532 // Fax: 970-493-6538 "If we knew what it was we were doing, it would not be called research, would it?" -Albert Einstein