Managing Sleep Problems in Dementia

Sleep problems are common for a person living with dementia. If you’re caring for someone with this condition, you’ll know how difficult it can be to cope with sleep disturbances; both for yourself and for the person in your care. It’s important to try to understand what can cause sleep problems for people living with dementia so that you can take steps to help the person that you are caring for with their sleep routine.

The following information and tips may help you both get a better night’s sleep.

The Most Common Sleep Problems with Dementia

While many older adults have difficulty with sleeping, people with dementia often find it even more difficult. In people with mild to moderate dementia, 25% are likely to experience sleep disturbance. Sleep disturbances tend to get worse as dementia progresses, with 50% of people with severe dementia experiencing sleep disturbances.

The most common sleep problems for people living with dementia include:

• Excessive sleepiness during the day
• Insomnia
• Difficulty falling asleep and staying asleep
• Frequently wakening during the night
• Waking up too early in the morning

People living with dementia often also experience what is often referred to as ‘sundowning’ during the evening or at night. Sundowning is the term often used for when a person with dementia becomes more confused, restless or agitated later in the afternoon or in the early evening. They may become more demanding, upset or suspicious and can sometimes even see or hear things that aren’t real, particularly at night.

Sleep apnea is also relatively common in people with Alzheimer’s disease. Sleep apnea causes breathing to start and stop repeatedly during sleep, and is one of the more serious sleep disorders.

For a person living with dementia, there are a number of factors that may contribute to sleep disturbances and sundowning:

• Being mentally and physically exhausted by the end of the day
• Changes in the body clock
• Less need for sleep, which is common among older adults
• Disorientation
• Dim lighting and increased shadows. This can cause confusion and fear.

How to Support a Better Sleep

In order to avoid sleep disturbances taking a toll on both the caregiver and the person living with dementia, the following tips may help:

• Identify Underlying Conditions: In some cases, conditions such as depression, or restless legs syndrome can be the cause of sleep problems. Treating these problems can help with sleep problems.
• Establish a Sleep Routine:A good routine can help promote a good sleep. This means sticking to regular times for meals, waking up and going to bed.
• Take Part in Physical Activity:Being physically active can help promote better sleep at night. This can be as simple as taking a long walk each day.
• Avoid Stimulants:Limit intake of alcohol, caffeine and nicotine later in the evening and at night, as these substances can interfere with sleep. Also, try to avoid turning on the TV if you wake up during the night, as this can make it more difficult to get back to sleep.
• Don’t Take Naps:While you may be tired after a night of disturbed sleep, napping throughout the day can make it more difficult to get back into a good sleep routine.
• Set a Peaceful Evening Mood: A relaxing atmosphere can help someone living with dementia to sleep better. Try reading out loud to the person, or play soothing music to them. A comfortable bedroom temperature can also help the person with dementia sleep well.
• Provide Adequate Lighting:Appropriate lighting at night can reduce the agitation that may occur in darkness. Regular daylight exposure can also help to address day and night reversal problems.
• Manage Medications: Certain medications, such as antidepressant medications, bupropion and venlafaxine, can lead to insomnia. In addition people with dementia may take cholinesterase inhibitors, such as donepezil, to improve cognitive and behavioural symptoms, but these medications can cause insomnia. If the person you are caring for is taking these kinds of medications, seek advice from a medical professional about the most effective way to manage their conditions as well as their sleep problems. Learning the techniques of Compassionate Touch® can help avoid reliance on some medications. Based on connecting with and comforting the person with dementia they are more likely to become calm. The techniques can be applied by anyone, and people with dementia will often sleep during and after the use of these simple tools.

Remember that Caregivers Need Sleep, Too

It’s important that carers also focus on their own sleep, because if you are tired, you will likely have less patience and less energy to care for a person with dementia. The person in your care may also pick up on your stress and become agitated. Try to ask other family members or close friends to take on some nights to care for the person with dementia. Or, if this is not possible, talk to a health professional or social worker to find out what help is available in your area. Just as applying Compassionate Touch techniques can soothe and calm the person with dementia, they can also soothe the carer as they apply them.

We hope that this article has provided some useful insight into common sleep problems with dementia. If you’re caring for someone with dementia and would like to know more about Compassionate Touch®, contact Brain Sparks to see where you can learn them.