Why Is Sleep Important For Health And Wellbeing
A person with dementia needs regular sleep to stay well. Most adults need between seven and nine hours of sleep a night. Sleeping well helps a person to be in a better mood, think more clearly, and maintain a healthy immune system. It can also help to prevent falls and accidents, and puts the body under less stress.
The two systems in the body that work together to control sleep are a persons body clock and sleep pressure.
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.
What Foods Are Bad For Dementia
New research finds that its not only what you eat, but also how you combine certain foods that can increase your risk of developing Alzheimers and other forms of dementia in later life. The foods most strongly associated with this risk were sugary snacks, alcohol, processed meats, and starches like potatoes.
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What Are The 10 Warning Signs Of Dementia
10 Early Signs and Symptoms of AlzheimersMemory loss that disrupts daily life. Challenges in planning or solving problems. Difficulty completing familiar tasks. Confusion with time or place. Trouble understanding visual images and spatial relationships. New problems with words in speaking or writing.More items
What Are The 6 Stages Of Dementia
Resibergs system:Stage 1: No Impairment. During this stage, Alzheimers is not detectable and no memory problems or other symptoms of dementia are evident.Stage 2: Very Mild Decline. Stage 3: Mild Decline. Stage 4: Moderate Decline. Stage 5: Moderately Severe Decline. Stage 6: Severe Decline. Stages 7: Very Severe Decline.
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Stage : Age Associated Memory Impairment
This stage features occasional lapses of memory most frequently seen in:
- Forgetting where one has placed an object
- Forgetting names that were once very familiar
Oftentimes, this mild decline in memory is merely normal age-related cognitive decline, but it can also be one of the earliest signs of degenerative dementia. At this stage, signs are still virtually undetectable through clinical testing. Concern for early onset of dementia should arise with respect to other symptoms.
Other Sleep Issues In People With Dementia
Sundowning is a phenomenon in which individuals with dementia experience increased agitation later in the day and in the evening. The symptoms of sundowning include confusion, anxiety, wandering, and yelling. Sundowning can contribute to insomnia and other sleep problems when these behaviors continue into the night. Possible causes of sundowning include the circadian rhythm changes that occur in dementia, as well as fatigue, depression, and pain.
People with dementia may also talk, yell, or cry out at night if they cannot sleep. Some dementia patients have a tendency to wander away from their homes, which can be especially dangerous at night. In dementia patients with REM sleep behavior disorder, shouting, grabbing, jumping, and other behaviors are related to dream enactment during sleep.
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How Do I Know If Someone With Dementia Is Struggling To Sleep
Look for changes in the persons behaviour such as frequent waking, getting out of bed and/or increased disorientation or confusion. Deprivation and/or disturbed; sleep is also a recognised risk factor for the development of delirium. Sleep can be disturbed by infections, due to an increased need to go to the toilet, dehydration and constipation as the person may be in discomfort. If you suspect these may be present an appointment should be made with the GP to investigate and treat any underlying causes.
If you do not know already, it is important to establish what is the usual pattern for people by asking the person. We are all different and people may have varying sleep patterns and need differing amounts of sleep.;It is common for sleep patterns to change as we get older too. It helps to establish regular routines and offer comfort & reassurance. If people are feeling insecure and unsafe, they will feel less able to relax and get to sleep.
If someone gets up in the middle of the night, try to establish any cause for waking and think about sitting with them for a short time in a quiet environment with low lighting before guiding them back to bed.;They may need to go to the toilet or be unsure about where they are. Having a night light and a clock which indicates day and night, may help orientate them and reduce distress .
What Is Sleep Pressure
Sleep pressure is the increasing need to sleep after being awake for a long time. The longer a person has been awake for, the more likely that they will feel sleepy, and the more deeply they are likely to sleep. As a person sleeps, the pressure to sleep gradually wears off and they become more likely to wake up.
Some stimulants, such as caffeine, work by blocking the chemicals that make a person feel sleepy.
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Where To Get Help
- Your local community health centre
- National Dementia Helpline Dementia Australia ;Tel. 1800 100 500
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care 1800 200 422
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Carers Victoria Tel. 1800 242 636
- Commonwealth Carelink and Respite Centres Australian Government Tel. 1800 052 222
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
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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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.
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.
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Rachel Thompson Admiral Nurse Professional And Practice Development Lead At Dementia Uktalks About How Dementia Affects Sleep And How Carers And Families Can Approach Sleep Disturbance And Its Possible Underlying Causes
Disturbances in sleeping patterns are common among people with dementia and can become more problematic as the condition progresses. Someone diagnosed with dementia can become increasingly restless, confused, agitated, or distressed, particularly as the sun is setting and it becomes dark outside. This is known as sundowning.
There are many different types of dementia and some people may present with a combination of types. Regardless of which type is diagnosed, each person will experience their dementia in their own unique way. All types of dementia can affect sleeping but for people with specific types of dementia particularly Lewy body dementia or Parkinsons disease dementia, sleep disturbance can be particularly common due;to physical changes in the brain.;For people with Lewy Body dementia this can include nightmares or night terrors and/or restless leg syndrome or uncontrolled limb movements.
Medications may also cause sleep problems, for example anti- cholinesterase inhibitor drugs ;such as Aricept, Exelon and Reminyl, can cause night time stimulation and dream disturbance so where possible these should not be taken in the evening. Pain is also a major contributor to sleep deprivation and is commonly unrecognised and undertreated in people with dementia.; If you suspect the person with dementia may be in pain contact your GP.
Sundowning And The Impacts Of Sleep Disturbances On Caregivers
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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How Do Dementia Patients Die
The actual death of a person with dementia may be caused by another condition. They are likely to be frail towards the end. Their ability to cope with infection and other physical problems will be impaired due to the progress of dementia. In many cases death may be hastened by an acute illness such as pneumonia.
Is There Anything You Can Do To Help
It is important to identify sleep problems in older adults. If you really find an elderly sleeping too much, you may want to learn more about the underlying cause first. This could be a warning sign of dementia, so you need to have a correct diagnosis first. Your doctor will help you develop a plan to improve things a bit.
Similarly, you may want to consider the medications you are giving to an elderly in your home. See if they are taking antipsychotic medications, antihistamines, cardiovascular medications, or other medications to treat a medical condition. Talk to your doctor and ask about the side effects of these medications. They may change the prescription to see if it improves the condition of the patient.
What’s more, Alzheimer’s disease can cause sleep disruptions and sleep problems, but you can help the patient by establishing a nighttime routine as well as a daytime routine that includes a degree of physical activity. Sometimes, an older adult in your home feels a bit left out, and this makes them feel bored and depressed. The solution is to sit with them, talk to them, and involve them in your day-to-day activities to make them feel active throughout the day.
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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.
How Will Poor Sleep Affect Health And Wellbeing
A person who doesnt get enough good-quality sleep is likely to be tired, irritable, have a low mood and be less able to think clearly. It can also make them more likely to fall or have an accident. This can make caring for them more difficult.
If the stress of caring is making you unwell, talk to your GP. You should try to get as much good-quality sleep as possible.;
Looking after yourself as a carer
Good quality sleep is important for both carers and people living with dementia. Read our advice on looking after yourself as a carer.
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Excessive Sleep In Elderly
When you are caring for an elderly person, you may get concerned when they start sleeping too much. As we age, sleep becomes lighter and we may be awakened by aching joints or the need to use a restroom.
Most seniors will usually compensate this with a nap during the day, which is quite normal. Sleeping in the day becomes an issue when the person seems to be sleeping most of the time instead of interacting with people.
If such a thing happens, you need to find out whether there are any reasons that are causing this. You may need the help of a doctor for this.
Is Excessive Sleeping Part Of The Vascular Dementia Stages
My mother is sleeping all night and virtually all day apart from a couple of hours. Does this happen as part of one of the stages?
She is not incontinent or aggressive and eats well when she is awake. She hasn’t forgotten our names but is starting to forget places , for example, she didn’t recognise the town she was brought up in and her short term memory is appalling.
I just don’t know what stage she is at, she was diagnosed about 4 years ago.
My husband has vascular dementia diagnosed 3 years ago. He is sleeps 11 hours at night and sleeps away most of the day in his chair. He doesnt want to be bothered to wake up. This scares me and Im not sure if I should try to keep him awake or just let him sleep.
My Mother does this too. After meals, right back to bed or her recliner. I was scared meds needed adjusting but it’s progression of disorder. This is everyday except when she agrees to let me take her to a local Sr Center for lunch with friends. We have games, puzzles, etc. She refuses any outdoor activity.
My husband was diagnosed 4 years ago too, He sleeps alot too. He’ll go to sleep about 7:30 and sleep until 9 or 10. Takes naps in afternoon too.
Sounds like later stages to me.
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