Lewy Body Dementia And Sleep

Lewy Body Disease Hereditary: Everything You Need To Know

A decline in intellectual function , a group of movement difficulties known as parkinsonism, visual hallucinations, rapid changes in behavior and intellectual abilities, and enacting dreams while asleep are all symptoms of dementia with Lewy bodies which is a condition of the nervous system . The average age of onset for this condition is between 50 and 85, making it a disease for older adults. People with dementia with Lewy bodies have a life expectancy of between 5 and 7 years, but it can be shorter or longer.

People with REM sleep behavior disorder are sometimes the first to notice that they have Lewy body dementia. It often develops before any other symptoms do. People with REM sleep behavior disorder often talk about and act out their dreams while they sleep. With dementia with Lewy bodies, this behavior gets less and less as other symptoms show up.

For those with dementia with Lewy bodies, dementia is often the second most prominent symptom to appear. This mental decline may start slowly or seem to come and go at first. People with dementia often have trouble with visual-spatial skills, like those needed to solve puzzles. People with this disorder may also have trouble communicating, low inhibitions, and poor executive functioning . Memory issues usually do not manifest until adulthood.

Understanding Lewy Body Dementia

Lewy body dementia symptoms are so similar to those of other forms of dementia that LBD can be misdiagnosed. This might make more sense when you consider that there are many types of dementia.

It may help to think of dementia as one large “umbrella” that slowly robs people of their ability to think, talk, remember, and use their bodies. Many diseases crowd underneath this umbrella, including:

• Alzheimers disease

• Struggle with incontinence

With dementia with Lewy bodies, cognitive changes may appear earlier than, about the same time, or shortly after any physical changes surface.

Combating Sleep Problems Associated With Lewy Body Dementia

April 9, 2019 by Norma Loeb

Lewy Body Dementia affects approximately 1.4 million Americans, and is most common in individuals over the age of 50. This disease is associated with a host of cognitive changes, and symptoms often include a change in sleeping habits. If your loved one has been diagnosed with Lewy Body Dementia and is experiencing trouble sleeping, it may be helpful to try the tips we share below.

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Does Quality Of Sleep Matter For People With Dementia

The quality of a person’s sleep gradually deteriorates as they get older. They tend to get less deep or slow-wave sleep, which helps to keep the brain healthy and refreshed.

Even though a person with dementia may end up sleeping more than a typical person of their age even as much as 1415 hours a day it is unlikely to all be good quality sleep.

Sleeping a lot can also be influenced by peoples sleeping patterns before they had dementia, as some people need more sleep than others.

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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Building A Lewy Body Dementia Care Team

After receiving a diagnosis, a person with LBD may benefit from seeing a neurologist who specializes in dementia and/or movement disorders. Your primary doctor can work with other professionals to follow your treatment plan. Depending on an individual’s particular symptoms, physical, speech, and occupational therapists, as well as mental health and palliative care specialists, can be helpful.

Support groups are another valuable resource for people with LBD and their caregivers. Sharing experiences and tips with others in the same situation can help people find practical solutions to day-to-day challenges and get emotional and social support.

What Are The Signs And Symptoms Of Lewy Body Dementia

The most common symptoms of LBD include changes in thinking abilities, movement, sleep, and behavior. The degree of symptoms can vary widely and people with LBD may not have every symptom. Common symptoms include:

• Trouble with attention, planning, multitasking, problem-solving, and reasoning. Memory problems are also common but may not be noticeable early on.
• Problems with visual and spatial abilities, such as judging distance and depth or misidentifying objects.
• Unpredictable changes in concentration, attention, alertness, and wakefulness.
• Visual hallucinations, which occur in up to 80% of people with LBD, often early on.
• Movement changes, such as tremor or muscle stiffness, known as parkinsonism.
• Sleep disorders, including rapid eye movement sleep behavior disorder in which a person seems to act out dreams while asleep, excessive sleep or lack of sleep, and restless leg syndrome.
• Depression, lack of interest, anxiety, ideas not based in reality, and other changes in mental health.
• Sensitivity to heat and cold, dizziness, poor sense of smell, and other changes in automatic functions of the body.

Individuals with mild symptoms can often function close to normally. As the disease progresses and thinking and movement abilities decline, people with LBD will need more help and may depend on caregivers full time.

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Therapy Following Your Diagnosis

Receiving a dementia diagnosis may feel disheartening. You might feel sad, angry, scared, or confused. Speaking with a therapist who works with clients who have received life-threatening medical diagnoses may be helpful. A therapist can help you come to terms with your diagnosis and address any fears you may have.

Coping With A Diagnosis

Being diagnosed with dementia can be an overwhelming experience. While there is no cure at present for LBD, or any medications aimed at specifically treating LBD, doctors are able to treat many of its symptoms. There are also a number of self-help strategies that can help improve symptoms.

If youve been diagnosed with LBD, its normal to feel many strong and painful emotions, including anger, fear, and uncertainty about the future.

Take time to adjust. As with any major life change, its important to give yourself time to adjust. Expect ups and downs as you do. You may feel that youve come to terms with your new situation for a while, and then suddenly feel overwhelmed by stress again.

Reach out for support. Living with Lewy body dementia is not easy, but there is help for this journey. The more support you have from family and friends, the better youll be able to cope with symptoms.

Talk to your loved ones about your wishes. Its never easy to talk about how you want your healthcare handled when youre unable to make decisions for yourself. But its important to let your loved one know what is important to you. Thinking about your choices today can improve your quality of life in the future and ease the burden on your family.

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Treatment Of Behavior And Mood Problems In Lewy Body Dementia

Behavioral and mood problems in people with LBD can arise from hallucinations, delusions, pain, illness, stress, or anxiety. They may also be the result of frustration, fear, or feeling overwhelmed. The person may resist care or lash out verbally or physically.

Medications are appropriate if the behavior interferes with the person’s care or the safety of the person or others. If medication is used, then the lowest possible dose for the shortest period of time is recommended.

The first step is to visit a doctor to see if a medical condition unrelated to LBD is causing the problem. Injuries, fever, urinary tract or pulmonary infections, pressure ulcers , and constipation can worsen behavioral problems and increase confusion.

Certain medications, such as anticholinergics and antihistamines may also cause behavioral problems. For example, some medications for sleep problems, pain, bladder control, and LBD-related movement symptoms can cause confusion, agitation, hallucinations, and delusions. Similarly, some anti-anxiety medicines can actually increase anxiety in people with LBD. Review your medications with your doctor to determine if any changes are needed.

Antidepressants can be used to treat depression and anxiety, which are common in LBD. Many of them are often well tolerated by people with LBD.

Parkinsons Alzheimers And Lewy Body Dementia

Since Lewy body dementia is commonly misdiagnosed for both Parkinsons and Alzheimers, it is helpful to understand how these diseases overlap.

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Educate Others About Lewy Body Dementia

Most people, including many health care professionals, are not familiar with LBD. In particular, emergency room physicians and other hospital workers may not know that people with LBD are extremely sensitive to antipsychotic medications. Caregivers can educate health care professionals and others by:

• Informing hospital staff of the LBD diagnosis and medication sensitivities, and requesting that the person’s neurologist be consulted before giving any drugs to control behavior problems.
• Sharing materials with health care professionals who care for the person with LBD. Materials are available from NIH, as well as the Lewy Body Dementia Association and the Lewy Body Dementia Resource Center.
• Teaching family and friends about LBD so they can better understand your situation.

What Is The Life Expectancy For People With Lewy Body Dementia

The average life expectancy of Lewy body dementia is five to eight years after the initial diagnosis. But some people with LBD live up to 20 years after their diagnosis.

This short average life expectancy could be due to a lack of knowledge regarding LBD among healthcare providers and the population and difficulty in distinguishing it from other similar conditions. This often leads to a delay in diagnosis, which delays the onset of specific therapy.

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Behavioral And Mood Symptoms Of Lewy Body Dementia

Changes in behavior and mood are possible in LBD and may worsen as the persons thinking abilities decline. These changes may include:

• Apathy, or a lack of interest in normal daily activities or events and less social interaction
• Anxiety and related behaviors, such as asking the same questions over and over or being angry or fearful when a loved one is not present
• Agitation, or restlessness, and related behaviors, such as pacing, hand wringing, an inability to get settled, constant repeating of words or phrases, or irritability
• Delusions, or strongly held false beliefs or opinions not based on evidence. For example, a person may think his or her spouse is having an affair or that relatives long dead are still living.
• Paranoia, or an extreme, irrational distrust of others, such as suspicion that people are taking or hiding things

Types Of Lewy Body Dementia And Diagnosis

LBD refers to either of two related diagnoses dementia with Lewy bodies and Parkinson’s disease dementia. Both diagnoses have the same underlying changes in the brain and, over time, people with either diagnosis develop similar symptoms. The difference lies largely in the timing of cognitive and movement symptoms.

In DLB, cognitive symptoms develop within a year of movement symptoms. People with DLB have a decline in thinking ability that may look somewhat like Alzheimer’s disease. But over time, they also develop movement and other distinctive symptoms of LBD.

In Parkinson’s disease dementia, cognitive symptoms develop more than a year after the onset of movement symptoms . Parkinson’s disease dementia starts as a movement disorder, with symptoms such as slowed movement, muscle stiffness, tremor, and a shuffling walk. These symptoms are consistent with a diagnosis of Parkinson’s disease. Later on, cognitive symptoms of dementia and changes in mood and behavior may arise.

Not all people with Parkinson’s disease develop dementia, and it is difficult to predict who will. Many older people with Parkinson’s develop some degree of dementia.

Caregivers may be reluctant to talk about a person’s symptoms when that person is present. Ask to speak with the doctor privately if necessary. The more information a doctor has, the more accurate a diagnosis can be.

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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.

Who Does Lewy Body Dementia Affect

Lewy body dementia typically affects people over the age of 50. The older you are, the more at risk you are for developing the condition. Men and people assigned male at birth are more likely to have Lewy body dementia than women and people assigned female at birth.

A family history of LBD and Parkinsons disease also increases your risk of developing it.

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Common Sleep Disorders 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 Do I Take Care Of Someone With Lewy Body Dementia

If you care for someone who has been diagnosed with Lewy body dementia , its important to learn about the condition and seek professional guidance to help care for them at home. Understanding LBD can help you cope with everyday challenges.

You may need to make changes to your home to make everyday life easier for them. For example, it helps to have a bright, cheerful and familiar environment. Its also important to make sure your home is safe and clear of any obstacles that could cause falls.

Your loved ones healthcare team can help guide you with these changes.

As insight and judgment skills decline in people with LBD, you may need to appoint someone else to oversee their finances. Before their decline in mental function is severe, its also important to clarify their wishes about care and financial and legal arrangements.

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What Is Lewy Body Dementia Roger Sextons Cause Of Death Explored

Roger Sexton died from Lewy body dementia, which is a progressive form of dementia following Alzheimers disease. Protein deposits, known as Lewy bodies, develop in nerve cells in the brain regions that help in thinking, memory, and movement.

The disease causes problems in mental abilities and people might have visual hallucinations and changes in alertness and attention. Common symptoms of this disease include visual hallucinations, movement disorders, poor regulation of bodily functions, cognitive problems, sleep difficulties, fluctuating attention, depression, and apathy.

Factors increasing the risk of Lewy body dementia include age, sex, and family history. The problem is more common in men than women and those who are above the age of 60.

The symptoms can take a worse turn at one point and can lead to severe dementia, aggressive behavior, depression, increased risk of falling and injury, and worse parkinsonian signs and symptoms like tremors and death about seven to eight years after symptoms first occur.