Normal Sleep Pattern Changes In Older Age
Research has documented a number of sleep changes that occur in healthy aging adults. These include bedtimes and wake times shifting to an earlier hour, taking longer to fall asleep once in bed, experiencing fragmented sleep, sleeping fewer hours per night, and spending less time in slow-wave and REM sleep. Although these changes parallel some of the sleep challenges seen in people with dementia, the sleep pattern changes in dementia patients tend to be more dramatic and disruptive.
You No Longer Grasp Concepts You Once Did
Problems with tasks that require abstract thinking, such as understanding numbers or reading a house planespecially if that was a strength beforeare an early symptom that can be caused by damage in the frontal and parietal lobes. For Chow, this appeared early at work in his inability to make simple calculations, but it also impeded his long-held role as the manager of his familys finances. After his diagnosis, Eva took over those duties.
Oneirophrenia In Dementia: When The Difference Between Dream And Reality Becomes Clouded
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Essex Partnership University Foundation Trust, UK
Correspondence: Carlo Lazzari, Kings Wood Centre, Turner Rd, Colchester, CO4 5JY, UK
Citation: Lazzari C, Shoka A, Papanna B, et al. Oneirophrenia in dementia: when the difference between dream and reality becomes clouded. Sleep Med Dis Int J. 2017;1:110-111. DOI: 10.15406/smdij.2017.01.00023
oneirophrenia, dementia, sleep, dream, aids dementia complex
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How Does Dementia Change Sleep Patterns
Circadian rhythm is a collection of physical and psychological processes; that guide our sleep-wake cycle by responding to indicators in our environment. People with dementia experience fundamental changes in their circadian rhythm that work against getting quality sleep on a regular schedule.
The suprachiasmatic nucleus is the part of the brain that serves as our internal clock and responds to cues, such as light, to indicate when we should be alert and when we should feel sleepy. Individuals who have Alzheimers diseasethe most common type of dementiaoften have damaged cells in the SCN and decreased cellular activity in this part of the brain. The result of this dysfunction is that patients are often unable to follow a 24-hour sleep-wake cycle and instead sleep excessively during the day and sleep much less at night.
Additionally, dementia is associated with changes in sleep structure. When we sleep, our bodies cycle through a series of sleep stages, from light sleep , to deep sleep , and then dream sleep . Slow-wave sleep and REM sleep are critical parts of how sleep works to restore the body and mind. People with dementia spend less time; in slow-wave sleep and REM sleep and more time in the earlier stages of sleep. This reduction of deep sleep and REM sleep can worsen as dementia progresses.
Do Offer Assurance Often
Many times, people with dementia may experience feelings of isolation, fear, loneliness or confusion. They may not be able to express this in the right way and thus may wander off or keep saying that they want to go back home, especially if they are in a senior living facility. This is not the time to shut them out. Its a good idea to assure them that they are safe and in a good place.
If you are close enough, provide a comforting hug every once in a while and remind them that they are in a place that has their best interest at heart. Where possible, engage in exercise or take a walk as even light physical activity may help to reduce agitation, restlessness and anxiety.
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The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
What Is Rem Sleep Behaviour Disorder
For most people, dreams occur purely in the mind while the body is resting.
However, people who suffer from REM sleep behaviour disorder physically act out their dreams while they are asleep.
They physically move around, walk, talk or hit out in their sleep.
It is often not diagnosed until it starts to prove a danger to the sufferer’s bed partner.
Studies of animals suggest that the symptoms of REM sleep behaviour disorder may be caused by lesions on the brain stem .
The disorder can be treated quite successfully; using medications such as antidepressants..
However, the link between dementia with Lewy bodies and the sleep disorder is not as strong in women, they added.;
Researchers at Mayo Clinic in Minnesota and Florida examined magnetic resonance imaging scans of the brains of 75 patients diagnosed with probable dementia with Lewy bodies.
The researchers then checked the patients’ histories to see if the sleep disorder had been diagnosed in them while they were under Mayo care.
While it is, of course, true that not everyone who has this sleep disorder develops dementia with Lewy bodies, as many as 75 to 80 per cent of men with dementia with Lewy bodies in our Mayo database did experience REM sleep behaviour disorder,’ said lead investigator Dr Melissa Murray, a neuroscientist at Mayo Clinic. ‘So it is a very powerful marker for the disease.’
She added that the study’s findings could improve the diagnosis of this form of dementia and that this can lead to better treatment.
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Lucid Moments Fluctuating Awareness And Dementia
by Health Professional
I recall a psychiatric nurse telling me about a patient with dementia who had not spoken for years and appeared to show little awareness of changing circumstances. They were on a trip out from the hospital and the bus they were sitting in was backing up very near a sheer drop. The patient suddenly swore and cried out that the driver should ‘……. stop or we will all die.’ Everyone was shocked.
Most caregivers will be able to tell you about a patient or loved one with dementia who suddenly has lucid moments. They seem more aware of themselves, their surroundings and are able to express and communicate themselves in ways they used to.
These apparent fluctuations in their features of dementia can at times be explained simply. Tiredness, mood changes, the effects of drugs or changes in their physical health, can all influence episodes where people do something with meaning and clarity. At other times the reasons seem less obvious.
When I worked with people with acquired brain damage one patient’s level of consciousness dramatically changed when he was taken on funfair rides. He was able to chat to people and enjoy himself. At other times his lucid moments resulted in violence. These changes were thought to be a result of improved blood flow to areas of the brain when he was physically flung about on the rides. It is true that appropriate drug treatments for older people cardiac and vascular problems can improve both skills and cognitive performance.
Understand Why Someone With Dementia Says Mean Things
First, its important to understand why this hurtful behavior is happening.;
Dementia is a brain disease that causes parts of the brain to shrink and lose their function, resulting in cognitive impairment.;
These different parts control functions like memory, personality, behavior, and speech. Dementia also damages the ability to control impulses, which means actions arent intentional.
Even though its difficult, do your best to remember that they truly dont intend the mean things they say.
These mean comments and hurtful accusations often happen because the person is unable to express whats actually bothering them.
Working to accept the fact that theyre not doing this on purpose helps reduce stress and makes their behavior easier to manage.
The overall strategy is to take a deep breath, remind yourself that its not personal, take care of; immediate discomfort or fear, and try to find the cause behind the behavior.
Next, look for long-term solutions that will help you get the support and rest you need to keep your cool in challenging situations like these.
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Youre Suddenly Bad With Money
A pattern of uncharacteristically poor financial decisions should set off alarm bells. When you have frontal-lobe damage, you lose judgment and can make rash, impulsive financial decisions, says Tartaglia. A frugal person starts giving away more money or buying things they dont needlike a furnace from a door-to-door salesperson. Shes seen patients who did significant damage to their families finances, as well as CEOs of companies who lost millions because nobody noticed the signs.
A combination of declining decision-making skills and memory can also lead to financial lapses. A 2020 JAMA Internal Medicine study found that people with dementia started missing bill payments up to six years before they were diagnosed.
When People With Dementia Experience A Different Reality
Sometimes people with dementia say things that suggest they have a different idea of reality or sense of what is really going on from our own. A person might, for example, ask to see his wife or tell us that he sees insects in his bedroom .
When we build up this awareness of an individuals ways of communicating, it helps us to find an effective response and also address the persons needs.
This is partly because the persons memory and ways of seeing things have been altered by dementia. Memory about current or recent events tends to become damaged, while memory about the past remains relatively intact so the past can seem more real than the present to the person with dementia. A person might see things that arent there because they are experiencing a hallucination or are having difficulties making sense of what their eyes are seeing.
What Should I Do If A Person With Dementia Is Sleeping A Lot
If the person is in the later stages;of dementia;and they have gradually started sleeping more and more, it is likely to be due to the dementia progressing.;;
However, if the excessive;sleeping has started more suddenly, or the person doesnt seem well in other ways, it may have another cause.;;
If this is the case you should speak to the GP, to rule out any infections or conditions that could be having an impact.
It may also be worth asking for a medication review with the GP or speaking to a pharmacist as medication can cause a range of side effects.;
If the person is sleeping a lot but it isnt having a negative impact on;them;it is often best to just go with it;and make sure they are comfortable.;
How To Deal With Dementia Behavior Problems
- How to Deal with Dementia Behavior Problems: 19 Dos and Donts
Dementia is a disease that affects millions of people across the globe every year. It is often a highly misunderstood condition that is marred by numerous misconceptions, which make the condition difficult to understand and study.
You should know that dementia is not a name for an illness, rather it is a collective term that describes a broad range of symptoms that relate to declining of thinking, memory, and cognitive skills. These symptoms have deteriorating effects that usually affect how a patient acts and engages in the day-to-day activities.
In advanced dementia stages, affected persons may experience symptoms that bring out a decline in rational thought, intellect, social skills, memory, and normal emotional reactivity. It is something that can make them powerless when it comes to living normal, healthy lives.
Relatives, caregivers, spouses, siblings, children and anyone close to a person who has dementia need to know how to deal with behavioral problems that surface because of the illness. Examples of dementia problems may include aggressiveness, violence and oppositional behaviors. Find out some of the vital Do and Donts when dealing with a dementia patient.
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You Forget Where Youve Put Things
Its not unusual to occasionally forget where you stashed your keys. But if you find that youre doing this regularly, leaving the stove burner on or frequently forgetting recent events and conversations, this could be a warning sign. Commonly, says Hsiung, people with this type of memory loss will ask loved ones the same questions over and over again.
Families can help a lot in recognizing these early symptoms, because if the persons memory is poor, they wont remember the problems they have in remembering, he says.
This sign is one that often points to Alzheimers disease. In this type of dementia, the hippocampusthe brain area involved in forming, storing and retrieving memoriesmay be affected first. In fact, short-term memory loss is the most common symptom among people with Alzheimers disease, whereas its less often an early sign in vascular dementia and Lewy body dementia, and rarely in FTD.
Medications and depression can also affect memory, so its important to check with your doctor, who might recommend a screening test, such as the Montreal Cognitive Assessment30 questions which quickly identify abnormal brain function.
How Does Dementia Affect Dreaming
The brain is the epicenter of dreaming. So, with that in mind, it makes sense that a disease that affects the brain would also affect dreaming. In fact, dementia affects sleep overall. Sleep is such a complex part of our bodys functioning and it is deeply rooted in neurological function. As dementia progresses and the brain degenerates, the sleep cycle is very negatively affected.
There are a variety of ways that dementia symptoms present themselves during the sleep cycle. Nightmares or bad dreams are more often associated with dementia, specifically Lewy body dementia that will be discussed more later.;
It is worth noting that there is less information on how memory loss affects dreams because those with dementia dont usually remember their dreams or sometimes cannot communicate details if they do remember. However, just because they cannot remember details does not mean they wont be left with feelings of fear and agitation that carry over into the day and increase confusion.;
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My Dad Has Dementia And Is Moving Into Residential Care Are There Any Care Homes With Dementia Units
Yes, there are. These residential units will allow your dad to live in a home environment with the benefit of trained staff on hand to help care for him. It may also be worth considering;finding a care home;in the right location to enable friends and family to visit regularly.;This may be more fitting for your dad and ease the transition.
If your parent/partner suffers from restless leg syndrome they move or twitch their legs uncontrollably, especially during the evenings and night-time. They may also experience tingling, burning and fizzing sensations in their legs too.;Symptoms can be relieved by rubbing and stretching legs – but it can be so bad that it wakes the person up. If you discover that your parent/partner has either of these medical conditions, its wise to see a GP and ask for help.
Do Not Try To Stop A Person Who Wants To Leave A Room
Staying in one place for long periods may result in behavior problems in the dementia patient. It is essential to have a safe environment where they can enjoy the outdoors without any problem. When someone tries to leave a room, do not force them to stop. Doing this may result in an extreme reaction such as severe distress or injuries.
Instead, it is best to accompany the patient so that they are safe. You can even suggest going for a drive around the block so that they can experience a new environment for a short period. If they do not want company, just let them go but stay close by to make sure that the patient is safe at all times.
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How Does Sleep Affect Dementia Risk
Experts suggest that sleep and dementia may share a bidirectional relationship. This means that while sleep could affect dementia risk and symptoms, the presence or absence of dementia also affects sleep quality. For example, one of the first Alzheimers disease symptoms in the brain is the accumulation of a protein called amyloid-beta, which eventually forms clumps called amyloid plaques. Animal studies and a small study in people have shown sleep deprivation to increase the levels of amyloid-beta in the brain. At the same time, Alzheimers patients with amyloid plaques have been shown to have worse sleep quality than Alzheimers patients who do not have amyloid plaques.
Additionally, sleep is known to be critical for our cognitive functioning and memory formation. Observational studies have shown that sleep issues are associated with cognitive decline and dementia. However, these studies do not prove a cause-and-effect relationship. Although more research is needed to better understand sleep and dementia risk, there are many proven steps you can take to improve your sleep.
The Development Of Other Degenerative Conditions
The behaviors associated with RBD can occur decades prior to the onset of other neurodegenerative changes. In fact, it seems that the majority of those afflicted with RBD will go on to develop other conditions. In particular, Parkinsons disease, Lewy body dementia, and multiple system atrophy seem to be associated with RBD. It may take years sometimes even decades before these other conditions develop. In some individuals, the other disorders may never fully manifest as death occurs due to other causes.
Though not all go on to develop the other associated conditions, it occurs with a high frequency. More than 80% of people with RBD go on to develop Parkinsons symptoms, for example. Though also commonly seen early in the other two conditions, far fewer will go on to develop these disorders.
It is important to obtain an accurate diagnosis of the behaviors. Other parasomnias may also manifest with movements during sleep. Certain medications, including antidepressants and anticholinergics, may provoke sleep behaviors. In addition, there are other medical disorders such as multiple sclerosis, narcolepsy, and stroke that might result in RBD.
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