Sleep Medications And Alzheimers
If your loved oneâs doctor prescribes medicine to help them rest, theyâll probably start at the lowest dose possible and stop the drugs as soon as sleep patterns improve.Â;
Medications include:
- Tricyclic antidepressants such as nortriptyline and trazodone
- Sleeping pills such as zaleplon and zolpidem
Doctors also sometimes prescribe drugs called antipsychotics such as risperidone . They can be helpful, but they also might increase the risk of death in some people with dementia. Youâll want to talk carefully with your loved oneâs doctor about this medicine before they take it.
Just as Alzheimerâs sleep problems can change over the years, so do the ways you can handle it. Always talk to your doctor about which options are best.
Signs Of Sleep Problems
Good sleep is important at any age. Experts think that when you sleep, your brain gets rid of things you don’t need. When you don’t get enough sleep, plaque-like substances build up. Sleep also helps you learn and store memories. And research shows youâre more likely to have problems doing those things if you have disturbed sleep.
Tell your doctor if you or a loved one:Â;
- Have trouble falling asleep
- Wake up a lot at night
- Stop your sleep too early
- Get agitated in the evening
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.
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Signs Of Dying In The Elderly With Dementia
Dementia is a general term for a chronic or persistent decline in mental processes including memory loss, impaired reasoning, and personality changes. Alzheimers disease is the most common form of dementia, accounting for 60-80% of all cases of dementia. It is also the 6th leading cause of death in the United States, and over 5 million Americans are currently living with Alzheimers disease.
Alzheimers disease and most progressive dementias do not have a cure. While the disease inevitably worsens over time, that timeline can vary greatly from one patient to the next.
Caring for a loved one can be challenging and stressful, as the individuals personality changes and cognitive function declines. They may even stop recognizing their nearest and dearest friends and relatives. As dementia progresses, the individual will require more and more care. As a family caregiver, its important to be able to recognize the signs of dying in elderly with dementia. Hospice can help by offering care wherever the individual resides, providing physical, emotional and spiritual care to the patient and support their family.
Medical Causes Of Sleeping Problems In Dementia
Sleeping problems may be caused by physiological or medical causes including:
- brain damage that affects the biological clock in the brain that directs our sleep patterns
- illness such as angina, congestive heart failure, diabetes or ulcers
- pain caused by conditions such as arthritis
- urinary tract infections that cause a frequent need to urinate
- leg crampsor restless legs, which can indicate a metabolic problem
- depressionthat causes early morning wakening and an inability to get back to sleep
- side effects of medication, such as antidepressants and diuretics
- snoring and sleep apnoea
- ageing that causes sleep patterns to change so that some people need more sleep and some need less.
Things you can try include:
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What You Can Do For Your Loved One
As an individual with dementia declines, you can help them by providing a loving and supportive presence. Sit with them. Hold their hand. Play music they enjoy.
One of the greatest gifts you can give your loved one is helping to get their affairs in order. Ensure that financial and healthcare powers of attorney are put in place, so you can make decisions when your loved one is no longer able. Look into funeral arrangements before you need them, so you dont need to make important decisions in a time of crisis.
Talk to your loved ones physician about the possibility of palliative care support in the home and hospice care when your loved one is ready.
A Person With Dementia Doesnt Always Fit Into One Stage
Dementia affects each person in a unique way and changes different parts of the brain at different points in the disease progression.
Plus, different types of dementia tend to have different symptoms.
For example, someone with frontotemporal dementia may first show extreme behavior and personality changes. But someone with Alzheimers disease would first experience short-term memory loss and struggle with everyday tasks.
Researchers and doctors still dont know enough about how these diseases work to predict exactly what will happen.
Another common occurrence is for someone in the middle stages of dementia to suddenly have a clear moment, hour, or day and seem like theyre back to their pre-dementia abilities. They could be sharp for a little while and later, go back to having obvious cognitive impairment.
When this happens, some families may feel like their older adult is faking their symptoms or just isnt trying hard enough.
Its important to know that this isnt true, its truly the dementia thats causing their declining abilities as well as those strange moments of clarity theyre truly not doing it on purpose.
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Sleep Time And Dementia
There appears to be a U-shaped curve when it comes to sleep length and cognitive decline. That means problems show up if you sleep too little or too much. But a lack of sleep is more likely to raise your chances of dementia.
Hereâs what research says about sleep time and dementia:
Short sleep . Research shows that one night of serious sleep loss raises your levels of beta-amyloid and tau. Those are proteins linked to Alzheimerâs disease. Insomnia also disrupts your slow wave sleep, which plays a part in learning and memory.
Long sleep . Itâs less clear why long sleep raises your chances of dementia. But your body may need more sleep to work well if you have another health condition, like sleep apnea or depression.
Sleep Six To Eight Hours Each Night
In the first study, researchers at Harvard Medical School studied more than 2,800 individuals ages 65 and older participating in the National Health and Aging Trends Study to examine the relationship between their self-report of sleep characteristics in 2013 or 2014, and their development of dementia and/or death five years later. Researchers found that individuals who slept fewer than five hours per night were twice as likely to develop dementia, and twice as likely to die, compared to those who slept six to eight hours per night. This study controlled for demographic characteristics including age, marital status, race, education, health conditions, and body weight.
In the second study, researchers in Europe examined data from almost 8,000 participants from a different study and found that consistently sleeping six hours or less at age 50, 60, and 70 was associated with a 30% increase in dementia risk compared to a normal sleep duration of seven hours. The mean age of dementia diagnosis was 77 years. This study controlled for sociodemographic, behavioral, cardiometabolic, and mental health factors, although most participants were white, better educated, and healthier than the general population. In addition, approximately half of the participants had their sleep duration measured objectively using a wearable accelerometer a device that tracked their sleep using body movements which confirmed the questionnaire data.
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The Role Of Vascular Dementia In Stroke And Memory Loss
Jason DelCollo, DO, is board-certified in family medicine and on the faculty of Philadelphia College of Osteopathic Medicine.
There is an important overlap between memory loss and risk factors for stroke that might suggest a condition called vascular dementia. What is vascular dementia? Learn about the symptoms and treatment of this condition and how it might affect sleep among those afflicted.
Do People With Dementia Sleep A Lot
There is one question that comes up a lot when discussing dementia and that is do people with dementia sleep a lot?
It has been established that individuals with dementia tend to sleep too much especially those who are already in the later stages.
This happens at night and during the daytime as well.
Below we will tackle this topic focusing on the reasons that may cause persons with dementia to oversleep and what to do when it happens.
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What To Do If Alzheimers Patients Sleep A Lot
This idea of patients sleeping a lot and not performing any activity or physiologic need like eating, drinking, and speaking may alarm both caregivers and relatives. It is understandable to panic or be concerned, especially if you have known these people to have been active most of their lives.
If the patient sleeps a lot but is easily woken if they need to eat or drink their medications, there is no need to get concerned as of the moment, this is just a normal symptom of their disease and we could expect this to get worse over time. Just try and allow him to follow an everyday routine so he can grow accustomed to what he needs to do at a certain time. You can also a good tip to turn off all the lights at night so the patients brain gets triggered to sleep.
If the patient chooses to sleep all through the day and this could pose harm to his condition since he would rather snooze than eat or drink, then you must ask his doctor about what steps to take so he does not compromise his health because of his diseases symptom.
What You Need To Know About Research Linking Sleep Deprivation And Dementia
Sleep deprivation has been linked to hypertension, obesity and diabetes and has long been suspected of having a connection to dementia. Now, a large new study has more clearly established that association by concluding that people who sleep less than six hours a night in midlife have a greater risk of developing late-onset dementia.
That doesnt mean middle-aged short sleepers should panic, according to experts. Although the study is an important step forward, much about the connection between sleep and dementia remains unknown, they said. Still, it cant hurt to work on your sleep habits while research continues, and youll find some strategies listed below.
In the study, European researchers followed nearly 8,000 people in Britain for 25 years, starting when subjects were 50. They found that those who consistently got six hours of sleep or less per night in their 50s and 60s were about 30 percent more likely to develop dementia later in life, compared with those who logged seven hours of sleep per night. That was independent of sociodemographic, behavioural, cardiometabolic, and mental health factors, the studys authors wrote. Findings were published in the journal Nature Communications in late April.
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Common Sleep Problems In People With Dementia
Sleep changes are common in older adults with and without dementia. Many seniors experience changes in the quality of their sleep, the number of hours they sleep, and how much time they spend awake at night. In fact, older adults;total sleep time decreases;by about 30 minutes per decade starting in middle age.
Sleep problems are even more common in people with dementia. The type and severity of sleep disturbances may vary depending on the;cause of your loved ones dementia;and the;stage of their disease. Sleep problems associated with dementia tend to get worse as the disease progresses.
Your loved one with dementia may experience the following sleep problems:
- Difficulty maintaining or falling asleep, which can be caused by;insomnia, problems with the sleep cycle, side effects of medication, or other factors.
- Sundown syndrome, which is common in people with Alzheimers and other forms of dementia, can contribute to problems with sleep.;Sundown syndrome;refers to increased confusion, agitation, anxiety, and aggression in the evening or during the night.
- Problems with movement during sleep, such as restless legs syndrome which is characterized by an uncomfortable urge to move the legs during periods of rest or rapid eye movement sleep behavior disorder, which makes people act out their dreams.
- Breathing disorders during sleep, such as sleep apnea, which affects about;50% of people with Alzheimers.
Circadian Rhythm Sleep Disorders
These are characterized by normal sleep patterns that usually happen at random times during the day. These are very common when a person is growing older.
It usually happens because of reduced exposure to natural light, a decrease in physical activity, as well as changes in circadian rhythms that come with aging.
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The Solution May Be Simple
However, if the behavior changes are severe, last more than a day, are accompanied by signs that the person may be getting sick or if the person has vital sign changes, consult a health care provider.
Doctors tell us that vital signs are a critical clue to whether a serious illness is developing. For this reason, its important for caregivers to learn to take vital signs. Free video instruction on vital signs is available at: .
Sleep For People Who Have Dementia With Lewy Bodies And Parkinsons Disease
The type of dementia you have can affect your sleep.
People who have dementia caused by Lewy body disease, such as Parkinsons disease or dementia with Lewy bodies ;are often sleepy by day but have very restless and disturbed nights. They can;suffer;from confusion, nightmares and hallucinations. Insomnia, sleep apnoea and restless legs are common symptoms.;
A person;affected with these types of dementia may often unknowingly act out their dreams by shouting and moving around in bed.
They can even cause injury to themselves and/or their sleeping partner. This is called rapid eye movement sleep behaviour disorder or RBD, and tends to happen from the earliest stages of the disease onwards.
This can be exhausting and often leaves the person feeling like they havent slept at all, so they are very tired and sleepy during the day.
It can be hard to stay awake during the day after a poor nights sleep but, if possible, its best to try to limit sleep during the day to small bursts or catnaps. Otherwise the persons body clock can become very confused and this makes sleeping well during the night even harder.
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Tau: A Direct Driver Of Cognitive Decline
In the study, Dr. Grinberg and the team analyzed the brains of 13 deceased people who had Alzheimers disease, as well as those of seven deceased individuals who had not experienced clinical neurodegeneration. The researchers obtained these samples from UCSFs Neurodegenerative Disease Brain Bank.
The team found that, in comparison with healthy brains, those affected by Alzheimers disease had a high level of tau across three regions that are key to staying awake, namely the locus coeruleus, the lateral hypothalamic area, and the tuberomammillary nucleus. Not only this, but these regions had actually lost 75% of their neurons.
Its remarkable because its not just a single brain nucleus thats degenerating, but the whole wakefulness-promoting network, notes the studys lead author, Jun Oh.
Crucially, this means that the brain has no way to compensate because all of these functionally related cell types are being destroyed at the same time, Oh explains.
For further clarification, the researchers went on to conduct a postmortem analysis of brain samples from seven people who had progressive supranuclear palsy and corticobasal disease. These are two forms of dementia that are characterized specifically by the overaccumulation of tau protein.
In these samples, the scientists did not find the same loss of neurons in areas connected with states of wakefulness, which suggests that this destructive loss may only occur in Alzheimers disease.
Dementia And Sleep: Tips For Helping Your Loved One With Dementia Sleep Better
Dementia and sleep problems often go hand in hand. The connection between dementia and sleep is a common source of stress for family caregivers. When your loved one with Alzheimers disease or another form of dementia doesnt sleep well, you probably dont get enough sleep either.
Read on to understand the causes of sleep problems in people with dementia and get tips for better sleep.
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