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Is Insomnia A Symptom Of Dementia

How Does Dementia Affect Sleep

Recognizing the early Signs of Dementia

A person with dementia may have problems with sleeping well or at the right times. Poor sleep may make the symptoms of dementia worse. Find out how dementia affects a person’s sleep.

  • You are here: How does dementia affect sleep?
  • Understanding sleep and night-time disturbance

    A person with dementia experiences physical changes in their brain because of their condition. These changes can affect how much, and how well they sleep.

    A person with dementia may have problems with sleeping at night, and may sleep more during the day. They may find it difficult to get to sleep or they may wake up in the night. The person you care for may not feel well rested when they wake up.

    Over time, if these problems happen often, poor sleep may make the symptoms of dementia worse. You may find this difficult to cope with.

    How To Get Dementia Patients To Sleep At Night: 8 Tips For Better Sleep

    If youre caring for a family member with dementia, improving sleep is probably a priority. Adequate rest can improve your loved ones mood, health, and quality of life and your own. Heres how you can help your family member with dementia get a better nights sleep.

  • Treat pain and other medical conditions. Treating chronic pain may help improve your loved ones sleep. If a condition such as sleep apnea or restless legs syndrome is disturbing your parents sleep, seeking medical treatment may also help.
  • Create a soothing environment. Make sure your loved ones room is set up to promote good sleep. The room should be dark, quiet, and cool .
  • Check for medication side effects. Many people with dementia take several medications. Some of these drugs, such as stimulants or diuretics, can interfere with sleep. In some cases, its possible to switch medications or change the time of day a certain drug is given to help improve sleep.
  • Encourage physical activity during the day. Help your loved one with dementia get some exercise each day. For example, you make take a walk together each morning. Its best to schedule physical activity early in the day, because being excessively tired in the evening may increase agitation.
  • Get some sunlight. Get outside or into bright lights soon after waking up in the morning to help regulate the sleep cycle. Dim the lights in the evening when its close to bedtime.
  • Avoid stimulants. Caffeine, alcohol, and nicotine may disrupt sleep.
  • Supporting A Person With Dementia And Sleep Disturbance

    Sleep problems tend to become more common and more severe as dementia progresses. They can happen daily, and last for a long time. The growing exhaustion can affect the person with dementia and you, their carer.

    Over time the person will need more support, especially if your own sleep is often disturbed. If the person you care for is frequently up in the night, it may be possible to have a night sitter.

    This is a carer who will look after the person with dementia at night, to help you to have a good night’s sleep. A person with dementia and severe sleep problems may need to be cared for by a live-in or visiting carer, or in residential care.

    Care homes: When is the right time and who decides?

    Read our advice and practical tips for carers on when is the right time for a person with dementia to be moved to a care home.

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    Associated Or Underlying Disorders

    Chronic insomnia. Clinical guidelines for evaluation of chronic insomnia in adults have emphasized the need to rule out comorbid medical and psychiatric problems . Although decreased sleep duration was shown in a large longitudinal study to be associated with an increased risk of incident dementia, the results did not remain positive after there was an adjustment for the presence of depression . Therefore, older patients who report insomnia need to be screened for symptoms of depression, and a trial of 1 or more sedative antidepressant drugs should be considered before attributing the insomnia to a new cognitive disorder.

    Take Steps Towards Reducing Stress

    Dementia and Sleep: How to Manage Alzheimer

    People with dementia are likely to experience stress that can make them suffer from insomnia.

    As a caregiver, you can try the following tips to help the person with the neurodegenerative illness reduce stress and probably sleep better.

    Let the weak person enjoy some alone time as they engage in the things they love to have a bit of fun and forget about their troubles for a while.

    It can be anything from doing hobbies like knitting, playing music, watching movies, and so forth.

    They can also socialize with their loved ones as they catch up and make each other laugh one of the best ways to relieve stress.

    Help the person talk about their expectations. If some are unrealistic, find a soothing way to tell them that they have to accept that some things cannot be changed.

    Although the person may shy away from support, try and give them as much as you can without forcing it so that you can reduce and finally eliminate the harmful effects of stress on the body and mind.

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    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:

    • Have trouble falling asleep
    • Wake up a lot at night
    • Stop your sleep too early
    • Get agitated in the evening

    Talk With A Senior Living Advisor

    Our advisors help 300,000 families each year find the right senior care for their loved ones.

    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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    What Is The Body Clock

    Our bodies sense natural light to know roughly what time of day or night it is. We also get a sense of time from routine daily activities such as mealtimes, to create a sleep and wake cycle over 24 hours.

    This tells our brains when its time to go to sleep and when to wake up again .

    The body clock of a person with dementia may become damaged, making it harder for them to feel awake and alert during the day, and sleepy during the evening.

    Managing Dementia And Insomnia

    Sleeping Pills Causing DEMENTIA? (Insomnia Medicines & Dementia Risk)

    Lack of proper sleep often leads to reduced functioning during the day and can also lead to increased health problems that may reduce the quality of life.

    Not getting enough sleep can also make dementia worse.

    This not only causes strain on ill individuals but caregivers as well. It is not uncommon for persons with dementia to experience early institutionalization because of insomnia.

    When caring for a person who has dementia and is experiencing insomnia as well, there are a few tips you can use to manage sleep problems, which we cover in detail below.

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    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.

    Do People With Dementia Sleep A Lot During The Day

    Some people with dementia sleep excessively during the daytime. They may feel like they cant stay awake, and they may take long naps that interfere with nighttime sleep and overall quality of life.

    Excessive daytime sleepiness is more common in people with Parkinsons disease dementia or Lewy body dementia than in those with Alzheimers. Some factors that may contribute to excessive daytime sleepiness include:

    • Insufficient sleep at night
    • Damage to brain cells caused by dementia
    • Changes in sleep pattern caused by dementia
    • Mental health conditions, such as depression
    • Other sleep disorders, such as sleep apnea

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    Eating A Healthy Diet

    A well-balanced and nutritious diet is important for everyone, more so, individuals with dementia.

    When it comes to mealtimes, make sure that persons with the illness do not take heavy meals and processed foods just before bedtime.

    If possible they should take their last meals at 6:00 PM. Anything a person eats after this should be low in carbs and sugar.

    Experts state that eating some foods around bedtime can help induce sleep.

    For instance, calcium is known to help in the production of a natural hormone called melatonin that is responsible for inducing sleepiness.

    This means that a person can have a glass of milk before they go to bed.

    Oatmeal is another option to consider.

    Sundowning And The Impacts Of Sleep Disturbances On Caregivers

    Can Dementia Cause Sleep Problems?

    In addition, many individuals with neurocognitive impairment, as occurs in dementia, may have disrupted sleep-wake cycles. They may find their desire to sleep at night is diminished while they nap away the afternoons. Sometimes loved ones may become suspicious for dementia when an individual begins doing unusual activities during the night, such as housecleaning at 3 a.m. or other activities. An irregular sleep-wake pattern usually manifests as a series of naps that occur within a 24-hour period rather than one full night of continuous sleep.

    The phenomenon of sundowning, in which a person with dementia becomes increasingly confused and agitated at nighttime, may represent a circadian rhythm problem. This behavior has been effectively treated with light exposure and melatonin, which may serve as time cues for reorientation.

    Often patients with dementia will be less confused if they are kept in familiar surroundings, such as a lifelong home, rather than a hospital or nursing home setting. In addition, the use of a routine may reinforce their memory and behaviors and allow for maximal success. It may also be possible that sundowning represents exhausted reserves that is, at the end of the day the individual no longer has the mental energy to remain vigilant about their orientation and thinking. As a result, they become or may appear more confused.

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    Aging And Cognitive Function

    As it is mentioned, dementia is a common disease among the elderly but just preclinical impairments may be expected decades before certain diagnosis and cognitive decline may not be seen until discussed mechanisms including the accumulation of amyloid and NFT, inflammatory processes, BBB disruption, loss of synapses, and neuron loss have reached a certain threshold .

    Therefore, based on the related mechanisms that can lead insomnia to the development of AD, and with attention to the high prevalence of insomnia and sleep disorders among the elderly age group, it can be assumed that insomnia has possible effects on AD pathogenesis and cognitive deficit in older adults with Alzheimers disease risk.

    Stay Away From Stimulants Before Bedtime

    Nicotine, caffeine, and alcohol are some of the things that can interfere with sleep.

    To manage dementia and insomnia, limit or completely avoid these substances when a person is about to retire to bed.

    Effects of caffeine can last many hours thus, end up interfering with sleep. This substance can lead to frequent awakenings, or challenges initiating sleep.

    Although alcohol can offer a sedative effect after a few hours of consumption, it is not advisable to take it at night because it often results in arousals as well as a non-restful nights sleep.

    It is also recommended that you keep away from stimulates during those wakefulness periods at night.

    These include things such as engaging in conversations, reading books, or keeping the TV or radio on.

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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.

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    How to Prevent Dementia and Treat Insomnia

    by Stacey Colino, AARP, July 24, 2018

    At its annual conference today, the Alzheimers Association highlighted research on treatments for some of the noncognitive symptoms people with dementia often experience. Such behavioral and psychological symptoms of dementia agitation, apathy, mood changes, hallucinations, sleep disturbances, wandering and the like are often among the most challenging for family members and caregivers to handle. They’re also particularly difficult to treat since no drugs are approved to specifically address these dementia-related symptoms, which are often the leading reasons patients are placed in assisted living facilities or nursing homes, according to the AA.

    “Most people think about Alzheimer’s disease as being a forgetfulness disorder, but a quarter of people present with nonmemory, noncognitive changes,” says James M. Noble, M.D., an associate professor of neurology at the Columbia University Irving Medical Center and a faculty member at the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain in New York City. “Noncognitive symptoms become quite stressful for caregivers. Seeing changes in personality in important relationships that may have been previously loving can be very challenging.”

    “I never know what I’m going to walk into there’s no predicting how his anger is going to be,” says Cheryl, who notes that her husband often has no recollection of encounters in which he’s yelled at family members.

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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.


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