Caring for someone with dementia can be a challenge. It can be even harder if your loved one doesn’t have a regular sleep pattern and needs around-the-clock care.
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“Sleep disturbances are common in dementia,” says clinical health psychologist and caregiver expert Lucille Carriere, PhD. “Poor sleep is a top reason why caregivers consider moving their loved one into a memory care facility.”
Dr. Carriere and behavioral sleep medicine expert Michelle Drerup, PsyD, DBSM, discuss the link between dementia and sleep. They also offer tips on what caregivers can do to help their loved ones and themselves.
People with dementia can experience different types of sleep problems, including:
Sleep issues can vary depending on the individual, type of dementia and disease stage. In general, the likelihood of a person with dementia experiencing sleep disturbances increases as the disease progresses.
“A typical pattern in advanced dementia is frequent periods of wakefulness at night and excessive sleeping during the day,” explains Dr. Drerup. “People may sleep longer overall, but the quality of their sleep is often poor.”
Healthcare providers aren’t sure exactly what causes sleep disturbances in people with dementia. It’s likely due to multiple factors, like:
The underlying disease causing dementia can affect the area of your brain that controls your internal clock. People with dementia may also produce less melatonin, a hormone that helps promote sleep.
“Sundowning causes confusion and restlessness in the late afternoon and evening,” says Dr. Carriere. “It can make preparing for bedtime and falling asleep very difficult.”
Sleep disorders interfere with sleep and can occur with other dementia-related sleep problems. Common sleep disorders include:
As you get older, you’re more likely to have trouble getting a good night’s sleep, says Dr. Drerup. Insomnia and sleep apnea are more common in older adults. Illness, pain and medications can also affect sleep.
Poor sleep can wreak havoc on your mood, energy and ability to perform everyday activities. It’s also linked to physical health conditions, like:
For people with dementia, a lack of sleep can magnify dementia-related behavioral, cognitive (thinking) and emotional symptoms. And caregivers may find themselves less equipped to engage with their loved one.
But a good night’s sleep can be within reach for you and your loved one. Helping someone with dementia get enough rest may involve changing their habits or environment. Dr. Carriere and Dr. Drerup offer six tips to help develop a better sleep schedule:
Going to bed and waking up at the same time each day can help maintain a consistent sleep schedule. It also provides cues that can reduce day-night confusion.
Reducing stimulation before bed and in the sleep environment can make it easier to fall and stay asleep:
You may not be able to cut out daytime napping entirely. If naps help your loved one function better, try limiting the length of the nap. And avoid naps in the late afternoon or evening.
Physical and social activities can benefit sleep and overall health. Getting outside or spending time in a sunny window can also help people with dementia distinguish day from night.
For people with dementia who wander during the night, safety is a top concern. Dr. Carriere recommends using a range of strategies to prevent wandering:
Certain medications can cause agitation or alertness in people with dementia. A healthcare provider can review medications and adjust as needed to reduce these effects.
Also, be vigilant about medications your loved one receives in the hospital. When in doubt, talk to the healthcare team about potential side effects.
Not all sleep aids are safe for people with dementia. Many prescription sleep medications affect brain health. Over-the-counter sleep aids, such as melatonin or nighttime pain relievers, may also not be appropriate.
“Even sleep medications people have taken for years can affect their brain differently when they develop dementia,” notes Dr. Drerup. “Check with your healthcare provider before giving any medications. Your provider can help assess the risks and benefits of a sleep aid and decide if it’s a safe option.”
It’s challenging to manage nighttime disruptions while also providing care and support during the day. Over the long term, juggling both can be unsustainable and lead to burnout.
If you’re not getting adequate sleep, Dr. Carriere recommends seeking help right away from your medical team. Potential resources for your loved one may include:
And think about your self-care. Can you bring someone in during the evening or night so you can rest? Getting the help you need can improve your well-being. It can also keep your loved one at home longer — a goal for many families.
“It’s important to look at dementia risk from a broader perspective,” says Dr. Drerup. “Many factors increase your risk, probably more than sleep. Your lifestyle plays a huge role.”
These steps can help reduce your risk of dementia:
If you find yourself worrying about sleep, you could be making things worse. Either way, it’s a sign you should talk to a healthcare provider about how you can improve your sleep. Don’t hesitate to get the care you need so you or your loved one can feel better.