Alzheimer’s and other dementias are known to cause sleep disturbances. This can also make things more difficult on the caregiver because if your loved one with dementia or Alzheimer’s doesn’t sleep well, it’s likely that you won’t either.
To complicate things, a lack of sleep can exacerbate dementia-related thinking and behavior. Of course, this is also true for those without Alzheimer’s. When we’re fatigued, we’re all more prone to annoyance and emotional instability. Sleep deprivation has also been demonstrated to affect the performance of even younger healthy persons on cognitive tests.
Therefore, getting adequate sleep is essential for people living with dementia and their dedicated caregivers. Now, evaluating and improving sleep disorders generally takes some work. However, as I’ll describe below, researchers show that sleep issues in a loved one could be improved.
The goal is to be aware of the most prevalent causes and to be ready to offer necessary details to the doctor. Here’s what you should know about what causes sleep issues, how to diagnose them, how to treat them, and some information on regularly used sleep drugs.
Why Do People Living With Dementia Have Trouble Sleeping?
Sleep patterns might alter depending on the stage of dementia, from not sleeping at all to sleeping far too much. What complicates matters is that dementia could make it increasingly difficult for someone to articulate what is wrong.
As dementia progresses, those living with dementia may not even be capable of expressing their grief, for example. As a result, other ways of communication, including body language and facial expressions, become even more crucial. I’ve included some of the concerns that might cause dementia individuals to have trouble sleeping.
1. Changes in the Brain
The alterations in the brain appear to be the major cause of restless nights in persons with dementia. According to specialists, dementia disrupts a person’s circadian rhythms by modifying brain cells. When a person’s circadian rhythms are interrupted, they frequently mistake morning for the evening. These alterations cause people living with dementia to become weary throughout the day, snooze often, and then stay awake at night.
2. Sundowning
In the late afternoon or about the end of the day, you may notice changes in the person’s behavior. The individual may become extremely worried and anxious and have delusions and hallucinations during this period. This might go on all night and make falling asleep difficult.
This is commonly referred to as ‘sundowning,’ but it is not always associated with the sunset or restricted to the end of the day. Sundowning can occur at any stage of dementia, although it is more prevalent in the middle and later stages.
3. Insomnia
Insomnia encompasses varied sleep issues, including difficulty falling asleep, frequent waking up during the night, nightmares, and getting up before dawn. As a result, the individual does not receive enough good-quality sleep.
Insomnia is a major problem among people living with dementia, and there are several causes:
- The individual may be experiencing pain or discomfort.
- Other health issues, such as heart or breathing difficulties, indigestion, constipation, urinary infections, and incontinence, may make sleeping more difficult.
- They might be upset, anxious, or sad.
4. Sleep Apnea
A collection of conditions known as sleep-disordered breathing affects a person’s ability to breathe correctly while sleeping. Obstructive apnea is the most frequent. While sleeping, the person’s airway compresses or narrows, causing loud snoring and preventing them from breathing correctly. Alzheimer’s disease and vascular dementia patients are more likely to develop it.
Your loved one having apnea may cease breathing for around a minute at once. When this happens, the oxygen levels in their brain can drop dangerously low, forcing them to wake up and gasp for breath.
And when your loved one is awake, the syndrome might produce sleepiness, depression, and headaches. It may also contribute to the progression of dementia symptoms over time.
5. Restless Legs Syndrome
Restless legs syndrome is a disorder in which a person’s limbs have a strong desire to move even when they are awake and at rest. It occurs most frequently at night. It might make it more difficult to fall asleep at night since the individual is unable to relax adequately.
They may experience unpleasant feelings such as hurting or tingling, which improve with movement. If they have trouble speaking vocally, they may massage, tap, or strike their legs to express their dissatisfaction. At night, an individual with restless legs syndrome may feel compelled to get out of bed and wander about.
Although the etiology of restless legs syndrome is unknown, it is frequent among persons who have dementia with Lewy bodies (DLB) or Parkinson’s disease. In addition, other health issues, including arthritis, diabetes, thyroid issues, renal difficulties, and iron deficiencies, may increase the chance of developing it.
6. Medication
People could be taking drugs that have a negative effect causing sleeplessness. This is prevalent with medications like donepezil, rivastigmine, and galantamine, which are used to treat dementia symptoms.
Some medications can make it effortless to fall asleep. However, the majority of them have unpleasant or even severe consequences, such as drowsiness and a higher risk of falling. As always, contact your healthcare provider with any concerns related to sleeping and to discuss any side effects you may notice in your loved one.
Sleep Aid For Elderly With Dementia
Several sleep aids and dementia treatments are medically treating a patient. In contrast, others are physical aids that may be utilized that can assist in reducing or managing symptoms. Before taking medicines, it is often suggested that a loved one attempt a physical sleep aid.
1. Get the Light Right
The bedroom must be as pleasant as possible to promote a peaceful night’s sleep. Using blackout curtains to block out outside noise during the night is an excellent idea. According to research, light treatment can help patients with dementia feel less restless and confused. Studies show that bright light exposure during the morning (typically >1000 lux at the cornea) helps improve sleep during the night, increase arousal during the day, sleep, decreases agitation, in those with Alzheimer’s disease or other related dementia’s. Light treatment with a consistent pattern might also help with body clock issues.
2. Safety Tip
If your loved one is prone to night wandering or needs to go to the bathroom frequently, you should consider using a light to keep them from stumbling in the dark. Consider purchasing a motion sensor lighting. Whenever movement is detected within three meters, a motion sensor light goes on automatically. Following 30 seconds of inactivity, it switches off.
This implies that the person can use the restroom or get out of bed in the middle of the night with less possibility of falling.
3. Review the Medicines Being Taken
Some dementia treatments have side effects that make it difficult to get a good night’s sleep, so talk to your parent’s doctor about the best time to take them. Don’t provide sleeping medications to anyone living with dementia without speaking to the doctor first since hypnotics or sedatives might make things worse.
4. Keep Them Active During the Day
Plan everyday activities like going for a walk outside, and seeing family and friends. Natural sunshine exposure is vital for body clock regulation, and going out during the day is the greatest way to maintain excellent physical health. This will also aid them in tiring out and sleeping better.
5. Follow a Routine
Try to keep your bedtime and wake-up times consistent throughout the week. Establish a bedtime and wake-up routine to help them understand what time it is. Bathing or showering, music, brushing teeth a warm beverage, or even the aroma of lavender on a blanket from a fragrant spray are all good ways to support improved sleeping patterns.
A perfumed pillow spray might help you relax and fall asleep. The lavender blend’s scent promotes sleep naturally.
6. Avoid Having Caffeine and Alcohol During the Evening
Avoid tea and coffee and other items that may contain stimulants from late afternoon onwards. Some carbonated beverages, like chocolate, may contain much caffeine to keep the person awake. For greater sleep quality and consistency, abstain from alcohol three hours before going to bed.
7. Consume Plenty of Fluids
It’s critical for people living with dementia to keep hydrated. Dehydration can lead to more disorientation and ailments like urinary tract infections (UTIs).
To prevent getting up in the middle of the night to use the toilet, it is better to promote the intake of most regular fluids, especially during the early hours of the day. If the person you care about likes a cup of tea in the evening, consider switching to decaf.
8. Check Eating Patterns
After a large meal, some people find it difficult to sleep, particularly if the food contains a lot of sugar. Limit yourself to a nutritious snack or small supper in the evening or smaller meals throughout the day.
9. Encourage Daytime Napping
Stopping a loved one from napping may be counterproductive and may possibly increase sleep issues. Instead, encourage a nap schedule during the day. Encourage sleeping at about the same time and in the same spot every day for the same amount of time.
Experiment with varied hours so that your loved one is still weary when it’s time for bed. For example, to encourage lighter sleeping, make it a habit to sleep on a chair rather than a bed. You may also organize more cognitively engaging activities to assist your parent in waking up after a snooze.
10. Reassure Them
Try to figure out why your loved one wakes up in the middle of the night. Calm them by repeating activities they associate with bedtime, such as quiet music, until they are prepared to go back to sleep. If they are prone to wandering in the night, a motion detector alarm system will help notify you when your loved one gets up. It can even help you sleep better knowing that you’ll be notified if they get up.
11. Create a Cozy Environment
In the evening, create a relaxing environment and keep to a nighttime routine. Playing some quiet relaxing music or reading a book may help make the environment more relaxing. The bedroom must be relaxing, with soft, breathable bedding that is neither too hot nor chilly.
Conclusion
Medications used to treat sleep issues in people living with dementia should always be discussed with a physician. Above, we listed some non drug sleep recommendations that can be trialed to see if this helps with sleeping impairments.
Non-drug measures such as getting lots of sunlight, exercising regularly, maintaining a consistent schedule, managing chronic diseases, and monitoring for discomfort can all assist. Furthermore, these generally increase a person’s overall quality of life.
Remember that sleep is essential for good health, especially for family caregivers. Speak with the doctor for ongoing sleep related concerns
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553247/
