What Causes Dyskinesia to Worsen in Advanced Parkinson’s Disease?
Neurological DisordersParkinson's Disease

6 Things That Can Make Dyskinesia Worse in Advanced Parkinson’s Disease

6 Things That Can Make Dyskinesia Worse in Advanced Parkinson’s Disease
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Updated on July 17, 2026
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Many people with advanced Parkinson’s disease will eventually develop dyskinesia, or erratic, writhing movements that typically occur in the face, arms, legs, or trunk.

These involuntary movements are usually a complication of levodopa, the most commonly prescribed Parkinson’s disease medication, and they typically begin after a few years of treatment.

However, in addition to too much medication, positive and negative emotions, stress, sleep, and diet can also play a role. Here are six common triggers of dyskinesia, plus strategies to keep it from worsening.

1. Stress

For someone with Parkinson’s disease, dealing with symptoms like stiffness, tremor, and slowness can be challenging, along with the basic activities of daily life, like preparing and eating meals.

“Even a cold or a long walk could be stressful,” says Kathleen Poston, MD, a professor of neurology at Stanford University Medical Center in Palo Alto, California.

Stress, in turn, can trigger dyskinesias.

 In fact, people with Parkinson’s disease commonly report that acute stress worsens their motor symptoms, such as freezing of gait, dyskinesia, and tremor.

One survey of 5,000 Parkinson’s disease patients found that stress worsened all disease symptoms, including dyskinesia.

However, the survey also found that stress-reducing interventions like mindfulness helped improve symptoms, including dyskinesia. Study participants also used physical exercise (walking, cycling, swimming, sports, yoga, Pilates, or tai chi) to reduce stress, which in turn improved their symptoms.

2. Anger

When someone with Parkinson’s becomes angry or frustrated — for example, after they’ve had a difficult conversation with a caregiver — they may experience more severe dyskinesia, says Dr. Poston.

 “Anything that prompts the release of adrenaline is likely to make dyskinesia worse,” she says.
This is because strong feelings of anger can trigger the release of the brain chemical norepinephrine (the fight-or-flight response), which increases involuntary movement.

Calming activities such as meditation, yoga, tai chi, massage, and breath work exercises can lessen your sympathetic nervous system’s responses to emotional situations and help you manage your dyskinesia.

Parkinson’s is a challenge not only for people who have the disease but also for caregivers and families. Communication is key in avoiding misunderstandings and conflicts, which can lead to anger, says Cathi A. Thomas, RN, assistant professor of neurology and program director of the Parkinson’s Disease and Movement Disorders Center at Boston University Medical Campus in Boston. “We have a lot of programs for newly diagnosed people [with Parkinson’s], and we offer support groups to help them cope better,” she says.

3. Happiness

Moments of joy and happiness can also bring on dyskinesia, as even strong positive feelings can trigger norepinephrine and increase involuntary movement.

 “Dyskinesia is influenced by what’s going on in your environment, so whether you’re happy, sad, or anxious, you can definitely see an increase in movement,” says Thomas.
It’s important to remember, especially in this case, that even though dyskinesia can make caregivers and family members feel embarrassed or uncomfortable, for most people with Parkinson’s, these movements aren’t a problem, says Alexander Pantelyat, MD, the director of the Johns Hopkins Atypical Parkinsonism Center in Baltimore. Some, in fact, may prefer to experience some extra movement as opposed to feeling “locked up,” which can happen with too little levodopa.

4. Too Little Sleep

Sleep problems are common in Parkinson’s disease, and poor sleep at night is associated with dyskinesia.

Symptoms like stiffness and cramping that accompany Parkinson’s can make it difficult to get a good night’s sleep. Research has found that people with the disease average just over five hours of sleep a night and wake up twice as many times as those who don’t have Parkinson’s, according to the American Parkinson Disease Association (APDA).

Keeping a regular sleep-wake schedule and taking no more than one short nap a day can help improve your shut-eye at night, according to the APDA.

5. A High-Protein Snack

“Knowing when, and how, to take medication [with] food can help reduce dyskinesia,” says Thomas. This is especially true when it comes to protein.

First, it helps to understand how levodopa works in the body and how the medication interacts with food: The amino acids found in protein are used in the body and the brain, but first, these acids must pass through the blood-brain barrier — the same pathway that’s used by levodopa, says Poston. Because of this so-called traffic congestion, a high-protein meal can interfere with the way the medication is absorbed, worsening the “on-off” fluctuations that can come with levodopa therapy.

For people with Parkinson’s disease who experience motor fluctuations, low-protein diets are often recommended to improve levodopa bioavailability. However, talk to your doctor and a dietitian, who can help you plan meals and snacks that have the right amount of protein for you.

6. Too Much Medication

Each person with Parkinson’s experiences symptoms a little differently than the next. The challenge for the physician is finding the dose and formulation of levodopa that provides the right balance of symptom relief while avoiding dyskinesia, says Todd Herrington, MD, PhD, a neurologist at Massachusetts General Hospital in Boston and an assistant professor of neurology at Harvard Medical School in Cambridge, Massachusetts.

Too much levodopa can trigger dyskinesia and possibly make other Parkinson’s symptoms worse, he says.

 But if people don’t take enough medication, it can leave them feeling slow, stiff, and even trapped in their own body. Be sure to work with your doctor to find the right treatment regimen for you.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Dyskinesia. Parkinson’s Foundation.
  2. Van Der Heide A et al. Stress and mindfulness in Parkinson’s disease – a survey in 5,000 patients. NPJ Parkinson’s Disease. January 18, 2021.
  3. Dyskinesia in Parkinson’s Disease. The Michael J. Fox Foundation for Parkinson’s Research.
  4. How Stress and Stress Management Impact Parkinson’s. Parkinson’s Foundation.
  5. The Difference Between OFF and Parkinson’s Dyskinesia. Davis Phinney. July 2, 2021.
  6. Parkinson’s Disease and Dyskinesia. American Parkinson Disease Association.
  7. Sleep Problems. American Parkinson Disease Association.
  8. Rusch C et al. To Restrict or Not to Restrict? Practical Considerations for Optimizing Dietary Protein Interactions on Levodopa Absorption in Parkinson’s Disease. NPJ Parkinson’s Disease. June 24, 2023.
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