Poor sleep is common among dementia patients, who often wake up during the night and fall asleep during the day. Some may not spend a full hour awake during the day or a full hour asleep during the night. Although sleeplessness may seem like a side effect of dementia, sleep disturbances may increase the risk of dementia, so focusing on sleep health is critical.
How Dementia Changes Sleep
It’s no coincidence that dementia patients often experience negative sleep changes. The disease can significantly affect sleep cycles and sleep quality.
Dementia patients may experience sleep disturbances including:
- Reversals in day and night sleep patterns
- Decreases in slow wave and REM sleep
- Frequent nighttime awakenings
- Increases in daytime sleep
It’s common for dementia patients to experience fragmented nighttime sleep and make up for lost sleep with frequent, short naps during the day.
- The brain degenerates in the area that governs circadian rhythms. Circadian rhythms, the inner clock that determines sleep and wake times, are found in the part of the brain that often degenerates with dementia.
- Degeneration of the brain and sleep quality increases with time. As dementia progresses, circadian rhythm alignment may further decline.
- Dementia negatively influence sleep regulation. Changes in the way the brain regulates the sleep and wake cycle can be a factor in sleep disturbances among dementia patients.
- Treatment of dementia can be a problem for sleep as well. Other factors that cause sleeplessness may include pain and prescription medications.
- Sleep disturbances can require institutionalization. Seniors with dementia may wake up during the night with confusion and even wander during the night, requiring around the clock supervision and care.
- Sundowning can be a major issue for sleep and behavior in dementia patients. It’s common for dementia patients to experience restlessness at night, often referred to as sundowning. Patients experience greater anxiety, confusion, and agitation late in the day, which may be caused by exhaustion at the end of the day, circadian rhythm misalignment, and an inability to distinguish lighting, cues, and reality.
- Elderly adults need less sleep. Even in healthy elderly adults, less sleep is needed at night. Although it’s a normal part of the aging process, lowered sleep needs can be disorienting for dementia patients.
10 Tips for Managing Dementia-Related Sleep Disturbances
Although sleep can be difficult for dementia patients, there are natural methods for improving the quality of sleep. These include:
1. Get treatment for sleep disorders
Insomnia, sleep apnea, restless legs syndrome, and other sleep disorders can exacerbate the sleep difficulties experienced in dementia. Seek help from a doctor who can offer treatment to improve serious sleep disorders.
2. Follow a regular schedule and bedtime routine
As circadian rhythms decline, it becomes more difficult for dementia patients to follow the cues of sleeping and waking. Following a regular schedule and bedtime routine reinforces those cues and can be reassuring for patients.
Dementia patients should maintain a regular schedule during the day and night, waking up and falling asleep at about the same time each night and day with consistent meals and activities. A bedtime routine can help wind down and send a signal that it’s time to go to sleep for the night.
3. Encourage activity during the day
Dementia patients suffering from poor sleep at night may nap frequently during the day. But napping should be avoided if possible, especially during the late afternoon or evening. Plan the day around exercise and activity to keep seniors awake and alert until it’s an appropriate time to go to sleep.
4. Don’t stay in bed all day
If seniors can’t be active, they should at least not spend the entire day in bed. Make sure they get time to get up and walk or at least sit in a chair. Ideally, they should spend time out of bed and in the sun each day.
5. Get exposure to light during the day
Exposure to light during the day can help remind the brain that it’s daytime, and time to be awake. Light exposure is especially helpful in the morning. Spending time outside, near a bright window (ideally open), or using a light box can be helpful for light therapy.
6. Meet needs before bed
Dementia patients should be made as comfortable as possible before bed. Make sure they’re not going to bed hungry, cold, or need to use the restroom. These can make it difficult to fall asleep and stay asleep, and lead to increased nighttime agitation.
7. Choose an appropriate mattress
People with dementia will sleep more soundly and wake up more well rested on a mattress that is appropriate for their needs. Consider mattress firmness, and look for a mattress with good edge support to reduce the risk of falling out of bed.
8. Make the patient’s sleep environment safe and healthy
Offer comfortable sheets and other bedding, as well as a nightlight so they can see better in the dark. Make their bedroom more secure with door and window locks to discourage wandering at night, or use motion detectors to signal alerts when dementia patients may be leaving their room at night.
9. Examine medications and other consumables
Some patients experience sleep difficulty due to medications that can interfere with sleep. Doctors and pharmacists should be informed of sleep difficulties and may be able to prescribe different medications or treatments that are less problematic for sleep.
Keep in mind that medications aren’t the only consumables that can negatively influence sleep. Caffeine and nicotine may be too stimulating, especially at night. Watching TV may be too exciting, and the blue light waves emitted from electronic devices can interfere with a healthy circadian rhythm. And although alcohol can help seniors fall asleep easier, it reduces REM sleep, so they won’t get as much deep sleep as they should at night if they’re drinking before bed.
10. Use natural sleep aids
When seniors struggle to sleep well, sleep aids can be helpful. They may offer help with getting the circadian rhythm properly aligned or managing sleep disorders with less potential for side effects than over the counter sleep medications.
Many dementia patients experience sleep difficulties as brain function declines. Fragmented sleep and sleep disturbances are common. But the tips shared in this post can help reinforce a healthy circadian rhythm and improve sleep for dementia patients.