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How To Get Dementia Patients To Sleep At Night

Fight Dementia And Sleep Problems With Bedroom Environment

How to improve sleep in dementia

A natural sleep aid for elderly with dementia is maintaining a healthy sleeping environment. Follow these guidelines to get some restful shut eye:

  • Use thick curtains to block any light from entering the room
  • Keep the room at a comfortably cool temperature
  • Dress in loose, minimal clothing so the skin can breathe
  • Consider playing white noise, nature sounds, or soft music for a relaxing atmosphere

Be Active And Exercise For At Least 30 Minutes Per Day

The Alzheimers Association recommends exercising at least 4 hours before bedtime.

Researchers found that daily habits of using a light therapy lamp and walking helped people with dementia to sleep 32% more during the night. Not only that, they also woke up an average of 5 less times during the night.

So walk, lift weights or canned goods, do some seated exercises, or work on some chores together.

Staying active will help your loved one to be tired by bedtime.

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.

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Use Aromatherapy And Hand Rubs

Research shows that breathing in certain essential oils like lavender, sweet orange, and cedarwood help people with dementia to have longer, uninterrupted periods of sleep throughout the night.

You can disperse the oils using a diffuser, by putting a few drops on a towel draped over the pillow at bedtime, or even using an aromatherapy lotion.

Hand rubs, especially using aromatherapy, have been shown to help people with dementia to relax and wake up fewer times during the night.

When your loved one sleeps better, you will sleep better too.

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Understanding What Keeps Dementia Sufferers Awake At Night

April 12, 2001 — Sleep disturbance is a very common and very problematic symptom of dementia. New research indicates that causes of this sleep disturbance may differ in different kinds of dementia. Hopefully, understanding these causes will lead to better treatments.

Dementia is a term used to refer to a loss of thinking abilities. Although there are many causes of dementia, it is most often associated with aging. The most common cause of dementia associated with aging is Alzheimer’s disease, which affects approximately one in 10 people over age 65 and nearly half of those over age 85.

Why Do Alzheimers Patients Struggle With Sleep

Changes in sleep quality and duration in older age are common. However, the sleep concerns seen in people with Alzheimers are often more severe and complex. There may be a reciprocal relationship between sleep issues and the other symptoms of Alzheimers. This means that sleep loss can worsen other symptoms, such as delusions, restlessness, and wandering, which can, in turn, make sleeping more difficult.

Getting enough sleep and spending sufficient time in deep sleep and rapid eye movement sleep are necessary in order for preservation of memories to occur. Memory loss is the primary symptom in people living with Alzheimers, and compared to older adults without the disease, Alzheimers patients spend progressively less time in deep sleep and REM sleep.

People with Alzheimers experience dramatic changes to their sleep-wake cycle. The sleep-wake cyclealso called circadian rhythmis the internal clock in our body that initiates physical processes related to wake and sleep. When this cycle is disturbed in Alzheimers patients, the result is not sleeping at night and sleeping too much during the day. Researchers attribute circadian rhythm disruption in Alzheimers patients, at least in part, to cellular changes in the brain caused by the disease. Dysregulated production of the sleep hormone, melatonin, in patients with Alzheimers may play a role. Other possible factors include decreased physical activity and less natural light exposure.

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Common Causes Of Sleep Change With Dementia

There are several factors that can cause older adults with dementia to have sleep problems:

    • Heart and lung conditions, such as heart failure or chronic obstructive pulmonary disease
    • Stomach-related conditions such as gastroesophageal reflux disease
    • Chronic pain from arthritis or another cause
    • Urinary conditions that make people prone to urinating at night, such as an enlarged prostate or an overactive bladder
    • Mood problems, such as anxiety or depression
    • Medication side effects, and substances such as alcohol
  • Chronic medical conditions and medications often affect sleep. Studies have found that older adults often experience secondary sleep difficulties, which means that the sleep problems are being caused by an underlying health problem. Many people diagnosed with Alzheimers have additional chronic health problems that may be associated with sleep difficulties. Common causes of secondary sleep problems include:
  • Many sleep-related disorders become more frequent with aging. Examples: sleep apnea and related conditions , which may affect 40 to 50 percent of seniors, as well as restless leg syndrome.

Physiological Or Medical Causes

Evening Activities to Help Someone with Dementia Get A Better Nights Sleep Phoenix
  • The brain damage caused by the dementia has affected the ‘biological clock’ in the brain, which directs our sleep patterns
  • Illness such as angina, congestive heart failure, diabetes or ulcers
  • Pain caused by such things as arthritis
  • A urinary tract infection which causes a frequent need to urinate
  • ‘Restless legs’ or leg cramps which can indicate a metabolic problem
  • Depression which causes early morning wakening and an inability to go back to sleep
  • Side effects of medication such as diuretics
  • Sleep apnoea and snoring
  • A need for less sleep as a person gets older

What to try

  • Discuss with the doctor stopping or changing diuretic medication if you feel this may be contributing to the problem
  • Arrange a medical check-up to identify and treat physical symptoms
  • Treat pain with an analgesic at bedtime if the doctor agrees
  • Discuss with the doctor whether sedatives may be contributing to the problem
  • Ask the doctor whether an assessment for depression may be necessary
  • Ask the doctor about possible side-effects of medication
  • In some situations it may be necessary to consider discussing with the doctor the appropriateness of either using tranquillising medication or sleeping medication. The latter may be helpful in the short-term to establish a better sleep cycle, but both types of medication can have negative effects, such as increased confusion

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How To Diagnose Dementia

To start helping doctors address your loved one’s dementia-related sleep issues, you need to understand what kinds of symptoms and problems he or she is experiencing.

Check the following list of questions that a group of geriatrics experts recommends for evaluating sleep problems. An additional 10 questions are contained in the journal article here.

  • What time do you normally go to bed at night? What time do you normally wake up in the morning?
  • Do you often have trouble falling asleep at night?
  • About how many times do you wake up at night?
  • If you do wake up during the night, do you usually have trouble falling back asleep?
  • Does your bed partner say that you frequently snore, gasp for air or stop breathing?
  • Does your bed partner say you kick or thrash about while asleep?
  • Are you aware that you ever walk, eat, punch, kick or scream during sleep?
  • Are you sleepy or tired during much of the day?
  • Do you usually take one or more naps during the day?
  • Do you usually doze off without planning to during the day?
  • How much sleep do you need to feel alert and function well?
  • Are you currently taking any type of medication or other preparation to help you sleep?
  • I always recommend families try to keep a journal related to these questions for at least a week. Some families may also be able to use a sleep tracker or activity tracker to gather useful information.

    Sometimes, additional testing is necessary, such as a sleep breathing study to evaluate sleep apnea.

    Why Do Dementia Patients Not Sleep

    Dementia experts arent exactly sure why dementia patients dont sleep well at night. However, there are some potential causes for sleep problems in elderly adults with dementia.

    A good practice is to monitor your loved one and keep a journal to help track different habits and changes.

    Here are some of the top causes of elderly adults with dementia not sleeping at night.

    Read Also: How To Assess Pain In Patients With Dementia

    What Sleep Disorders Are Common In People With Dementia

    People with dementia are frequently affected by sleep disorders. The following sleep disorders are found most often in older adults, but they are seen at even higher rates in people with dementia.

    • Restless legs syndrome : RLS is characterized by an overwhelming desire to move the legs, especially at night. RLS is common in people with a type of dementia called Lewy body dementia.
    • Periodic limb movement disorder : PLMD causes uncontrollable movements of the arms and/or legs at night. Many patients with PLMD also have RLS.
    • Obstructive sleep apnea : OSA is a condition marked by nighttime airway collapse leading to brief lapses in breathing. OSA is particularly common with Alzheimers disease, occurring in 40% of patients. Having OSA also increases ones risk of developing dementia.
    • REM sleep behavior disorder: REM sleep behavior disorder causes individuals to act out their dreams, sometimes in dangerous ways. It is most often found in individuals with Lewy body dementia and is sometimes the first symptom that arises with this type of dementia.
    • Depression: Although depression is a mood disorder, it is associated with insomnia and other sleep disturbances. Depression is common in people with dementia, and it is seen at increasing rates as dementia progresses to more severe stages.

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    As dementia progresses, sleep problems along with other difficult dementia symptoms tend to get worse. This may be a good time to evaluate whether you need additional support to help ensure your loved ones health and safety and your own. Learning what to expect at each stage of dementia can help you plan for adequate care.

    Heres what you should know when caring for someone with dementia and sleep problems:

    • Dont use physical restraints. Many people believe its best to restrain their loved ones in bed at night to prevent wandering. This may do more harm than good. Instead, if you have a bed with guard rails, raise the rails. This may help to deter them from climbing out of bed and wandering.
    • Dont do it alone. Consider taking shifts with another family member or looking into respite care. Respite care, or short-term care, gives you a chance to take a break while providing a safe environment for your loved one.
    • Reduce stimulation. To allow for a calming, soothing environment, avoid loud noises or a lot of activity during the evening and night.
    • Prioritize your health and rest. Taking care of a loved one with dementia and sleep problems may take a toll on your own mental health. Consider getting help from family members or exploring other care options, such as memory care, which provides 24-hour specialized care for people with memory loss.

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    Faqs About Dementia Sleep Problems

    Caring for a patient with dementia and sleep problems is hard work. When the dementia patient is not sleeping well, it is very easy to become exhausted yourself. To give the best care, the carer needs to look after themselves. In addition to the following questions that some people have asked regarding how to get dementia patients to sleep at night, you should visit our guide on caring for someone with dementia.

    Signs That Someone With Dementia Has Trouble Sleeping

    Unless youre sharing a bed with the person or have a monitor like a FitBit to track sleep, it might be hard to tell if your loved one has trouble sleeping.

    Waking up three or more times during the night is one example of poor sleep.

    Troubled sleep can also mean waiting more than an hour to fall asleep or more than 30 minutes to fall back asleep.

    If you cant monitor their sleep at night, look for these symptoms: aggression, excessive daytime sleeping, increased confusion or trouble finding the right words, falling out of bed at night, or the obvious theyre awake and active during the night.

    So what can we do to help promote a better nights sleep? By preparing for it all day.

    Here are five evidence-based tips:

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    Sleep Aids: Medications Melatonin And Dementia

    In some cases, the doctor may prescribe medications to help your loved one sleep. However, older adults with cognitive impairment are more likely to experience side effects from sleep-inducing drugs, so those medications arent usually recommended for long-term use.

    Some studies show melatonin may improve sleep in people with mild to moderate dementia. It may also help reduce agitation and confusion late in the day. Check with your loved ones doctor before starting any over-the-counter supplements or sleep aids.

    Get An Accurate Lighting

    Less sleep increases your risk for dementia

    The possibility of a good nights sleep is dependent on how comfortable the bedroom is. Getting the bedroom to be comfortable is a major effort you need to take in getting your patient to sleep at night. You can use blackout curtains at night to eliminate every form of outside disturbances.

    Research on dementia patients outlines that light therapy reduces confusion and restlessness in people suffering from this condition. If you wish to consider this therapy, check for violet-colored light that enhances drowsiness and full-spectrum fluorescent light used in the first 2 hours of every day.

    The essence of this is to create a reality of the different lights needed for sleep time and other activities. A light therapy following a definite pattern also helps to reset the body clock.

    While using dim lights, you need to also consider safety. If you notice your patient makes a frequent visit to the toilet then you will have to consider getting a kind of low light that will illuminate the room to an extent and prevent falling in the dark.

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    Common Causes Of Sleep Changes And Problems In People With Dementia

    Its hard to manage a problem if you dont understand why it might be happening. There are several factors that can cause older adults with dementia to have sleep problems. These include:

    • Sleep changes with aging. Healthy aging adults do experience changes with their sleep as they age. Sleep becomes lighter and more fragmented, with less time spent in deep REM sleep. One study also estimated that total sleep time decreases by 28 minutes per decade, starting in mid-life. Although these changes are considered a normal part of aging, lighter sleep means its easier for aging adults to be woken up or disturbed by any other sleep-related disorders or problems, such as arthritis pain at night. Aging is also associated with a shift in the circadian rhythm, so that many older adults find themselves sleepy earlier at night and hence wake up earlier in the morning. For more, see here: How Sleep Affects Health, & Changes With Aging
    • Many sleep-related disorders become more frequent with aging. Common sleep-related disorders include sleep apnea and related conditions , which may affect 40-50% of seniors, as well as restless leg syndrome, which is thought to be clinically significant in 2.5% of people.

    Hence, its not surprising that sleep problems are so common in people with dementia! Now lets talk about what can be done to improve things.

    How To Diagnose The Sleep Problems Of A Person With Dementia

    Like many problems that affect older adults, sleep problems in dementia are almost always multifactorial, which means that there are usually several underlying issues creating the problem.

    Multifactorial problems can be improved, especially if a family and the doctors are diligent about trying to identify as many contributing factors as possible. But youll need to start by helping the doctors understand what kinds of sleep-related symptoms and problems a loved one is experiencing.

    Here is a list of questions that a group of geriatrics experts recommends, for evaluating sleep problems.

  • What time do you normally go to bed at night? What time do you normally wake up in the morning?
  • Do you often have trouble falling asleep at night?
  • About how many times do you wake up at night?
  • If you do wake up during the night, do you usually have trouble falling back asleep?
  • Does your bed partner say that you frequently snore, gasp for air or stop breathing?
  • Does your bed partner say you kick or thrash about while asleep?
  • Are you aware that you ever walk, eat, punch, kick, or scream during sleep?
  • Are you sleepy or tired during much of the day?
  • Do you usually take 1 or more naps during the day?
  • Do you usually doze off without planning to during the day?
  • How much sleep do you need to feel alert and function well?
  • Are you currently taking any type of medication or other preparation to help you sleep?
  • Do you have to get up often to urinate during the night?
  • Do you often feel sad or anxious?
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