Many who suffer from Alzheimer’s disease do not sleep well at night. Unfortunately sleep problems are common with Alzheimer’s disease due to changes in the circadian cycle, but scientists do not completely understand why sleep disturbances occur.
While older people in general have problems with sleep due to age changes alone, (such as increased frequency and duration of awakenings, decrease in both dreaming and non-dreaming stages of sleep and day time napping), these sleep difficulties are more severe with the progression of Alzheimer’s disease. Alzheimer’s disease may reverse the sleep wake cycle, causing daytime drowsiness and night time restlessness.
If you are caring for a loved one with Alzheimer’s disease or dementia, lack of sleep by your loved one also means that you are unable to get adequate sleep, you may feel exhausted, and this challenges your ability to care for someone with dementia.
While there is seldom a single, easy, quick fix for sleeping problems, there are several things a caregiver can do to help maintain normal sleep-wake patterns.
- Expose the person to natural outdoor daytime light and keep sleeping areas dark at night to reinforce day and night
- Plan for only short morning, or early afternoon naps
- Provide opportunities for moderate regular daily exercise, but no later than four hours before bedtime
- Plan activities, exercise and any stressful care routines in the early day
- Maintain regular bed and arising times
- Use the bedroom only for sleep
- Provide a pleasant before bed routine
- Do not switch the Television on after the lights are out or if the person awakens
- Avoid caffeine, nicotine or alcohol especially in the evening
- Avoid large, heavy meals and excessive fluid intake at night
- Offer a light bedtime snack to avoid nighttime awakenings due to hunger
- Ensure the person has emptied their bladder before going to bed
- Reduce noises at night and make sure the room is not too hot
- Keep pets away from sleeping areas at night
- Consider separate beds or bedrooms if you have problems that may disrupt sleep (for ex. snoring, restless legs etc).
- Use a small night light in the bedroom and bathroom to minimize confusion in case they waken and need to use the bathroom
- If the individual tends to wander at night, consider installing an alarm on the outside door or a lock in an unlikely place (such as near the bottom of the door) to prevent the person from leaving the home as well as attend to any safety concerns
- Do not lay out the clothing for the next day as it may act as cue for them to get up and get dressed
- If the person is having troubles falling asleep, consider soft music, a warm decaffeinated drink or a warm bath
- Treat any pain symptoms
Try to determine why the person is waking up in the night so that you can determine which strategies are most effective. For example, some people with Alzheimer’s disease have other coexisting health problems that affect sleep.
These include, sleep apnea, restless legs syndrome, depression, and infections such as a urinary tract infections. In many situations these problems respond well to treatment. As well, it is important to note that certain medications to manage Alzheimer’s disease will also negatively affect sleep.
For more information on Alzheimer’s Care, contact Spring Arbor.