Do Sleep Medications Increase Dementia Risk
Between 5070 million Americans live with a sleep disorder. While getting a bad nights sleep has been linked to an increased dementia risk, researchers have also been turning their attention to whether sleep aids like Seroquel, TYLENOL PM, Benadryl and Doxepin could raise your chances of developing dementia. At the recent Alzheimers Association Conference, researchers revealed new findings on the impact of sleep medications on dementia risk.
How To Improve Problems With Dementia And Sleep
The exact approach will depend on which underlying factors are causing the problems. Still, certain general approaches have been found to improve the sleep of many with dementia. These include:
- Outdoor light or bright light therapy during the day Bright outdoor light helps keep the circadian signals on track. For older adults who cant get outside for at least an hour per day, bright light therapy with a special lamp might help. A study found that bright light therapy in Alzheimers patients improved sleep.
- Increasing daytime physical activity Research has suggested that walking during the day can help improve nighttime sleep in people with Alzheimers.
- Optimizing environmental cues for sleep This means keeping the sleeping environment dark and quiet at night. This is especially important in nursing homes, which have sometimes been found to have staff active at night.
- Establishing a regular routine with a consistent wake-up time The ideal is to have a consistent bedtime and wake-up time, but many experts believe its best to start by focusing on a consistent wake-up time.
A research study published in 2005 found that training dementia caregivers to use these techniques in combination led to improved sleep of the care recipients with Alzheimers.
I Care For More Than One Person With Dementia And Wonder How To Keep Dementia Patients Not Sleeping In Bed At Night Should I Put Them To Bed Straight Away
According to the Alzheimers Association, patients can spend up to 40% of their time lying in bed awake, this equates to sleeping too much during the day. If the patient does get up, dont try to get them back to bed. Try to restart a small bedtime routine instead of putting them straight to bed. Keep lights low, take them to the toilet, play relaxing music or read to them for a bit to calm them down.
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Behavioral And Multicomponent Interventions
Many behavioral treatments for insomnia, including stimulus control, sleep restriction, progressive muscle relaxation, biofeedback, sleep hygiene education, paradoxical intention, and multicomponent cognitive-behavioral therapy, are known to be effective with older adults . Because of the risk for sedating medication side effects, behavioral strategies are also commonly recommended as first-line treatment for sleep-disturbed individuals with dementia. Standard recommendations include maintaining regular bedtimes and rising times, limiting daytime napping, and restricting time in bed. Dietary recommendations include establishing consistent meal times avoiding alcohol, nicotine, and caffeine and emptying the bladder before bedtime. The sleep environment should not be overly hot or cold, and an effort should be made to reduce excess ambient light and noise .
They Wake Up A Lot During The Night To Use The Loo And I’m Worried They May Get Lost Or Confused Should I Wake Up Too To Help Them
It is normal that older people will need to use the loo more often during the night. This can be difficult if a person also has dementia as they might forget why they’re up, where the toilet is or that they should go back to bed. Start by looking at your parents drinking and eating habits. If they are eating and drinking large amounts in the evening this will increase the need for them to visit the toilet. Limit their intake from late afternoon and enjoy a main meal at lunch. Next make the route to and from the toilet as clear as possible by using signs and plug-in nightlights. Try using pictures if it helps. It might also help to make the lights in the bathroom motion activated for when they get there. If you are still worried or you find they still get lost, it may be that you will have to help them. A monitor or bed-exit sensor will help you to wake up when you need to.
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Sleep Aids For Dementia Patients
Sleep inducing medications can cause negative side effects in dementia patients. These include worsened cognition and an increased risk of falling. Therefore, recommended sleep aids for people living with dementia are non-drug based and aim to improve sleep routine and the sleeping environment. You can find a full list of dementia products on our dementia products page.
Professional Help With Dementia Sleep Issues
Dementia is a disease that commonly affects an elderly adults sleep cycle. Experts still dont know precisely why dementia patients dont sleep but believe its linked to brain alterations. Other dementia sleep issues like sleep apnea or restless leg syndrome can also make it difficult for loved ones with dementia to fall asleep or stay asleep at night.
If your loved one with dementia struggles with sleep and youre wondering how to keep dementia patients in bed at night, you may want to try:
- Keeping them on a consistent schedule
- Ensuring they exercise regularly
- Creating a calming nighttime routine
Theres also overnight dementia care for family caregivers looking for professional, hands-on assistance.
Stowell Associates in Wisconsin is a premier in-home dementia care provider. We train and equip both our Care Managers and Caregivers to handle the demands of dementia care. With our 24-hour care service, your loved one will receive the best care during the day and nighttime hours. It will also provide you with peace of mind knowing your loved one is receiving the care they need.
Contact us today to talk with a Care Advisor. Theyll help you better understand all the benefits of full-time dementia care.
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Sleep Problems In The Elderly
DAVID N. NEUBAUER, M.D., Johns Hopkins Sleep Disorders Center, Baltimore, Maryland
Am Fam Physician. 1999 May 1 59:2551-2558.
See related patient information handout on sleep problems in the elderly, written by the author of this article.
Refreshing sleep requires both sufficient total sleep time as well as sleep that is in synchrony with the individuals circadian rhythm. Problems with sleep organization in elderly patients typically include difficulty falling asleep, less time spent in the deeper stages of sleep, early-morning awakening and less total sleep time. Poor sleep habits such as irregular sleep-wake times and daytime napping may contribute to insomnia. Caffeine, alcohol and some medications can also interfere with sleep. Primary sleep disorders are more common in the elderly than in younger persons. Restless legs syndrome and periodic limb movement disorder can disrupt sleep and may respond to low doses of antiparkinsonian agents as well as other drugs. Sleep apnea can lead to excessive daytime sleepiness. Evaluation of sleep problems in the elderly includes careful screening for poor sleep habits and other factors that may be contributing to the sleep problem. Formal sleep studies may be needed when a primary sleep disorder is suspected or marked daytime dysfunction is noted. Therapy with a benzodiazepine receptor agonist may be indicated after careful evaluation.
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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Check For Other Medical Conditions
Both sleep apnea and restless leg syndrome are associated with increasing age and have symptoms which will easily wake someone with dementia. To identify if your parent or partner has sleep apnea, you may have to watch them while they sleep. Someone with this condition will pause when they breathe, almost momentarily stopping breathing. This momentary lack of air can wake someone up, and is really quite frightening for the person sleeping next to them as they wait for the next breath.
If your parent/partner suffers from restless leg syndrome they move or twitch their legs uncontrollably, especially during the evenings and night-time. They may also experience tingling, burning and fizzing sensations in their legs too. Symptoms can be relieved by rubbing and stretching legs – but it can be so bad that it wakes the person up. If you discover that your parent/partner has either of these medical conditions, its wise to see a GP and ask for help.
Restless Leg Syndrome And Related Conditions
According to the National Institute of Neurological Disorders and Stroke, about 10 percent of the United States population could have restless leg syndrome with or without a dementia diagnosis.
Its more common in women but happens in men, as well. For example, my husband suffers from a related condition called periodic limb movement disorder, which makes his muscles twitch while he is sleeping and this affects his sleep quality.
Restless leg syndrome causes pain and discomfort in the legs unless moving them. They might feel burning or tingling and even charley horses.
Thus, even if older adults with dementia wanted to sleep, their restless leg syndrome or similar condition would force them into another sleepless night.
They might decide to get out of bed to relieve the discomfort in their legs and then lose track of what theyre doing. Then you wake up and find them rummaging through the house in the middle of the night.
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How Do You Stop Dementia Patients From Getting Out Of Bed
When a caregivers sleep patterns keep getting interrupted, its very easy to feel at the end of your rope. You might even have the idea to use physical restraints to keep your parent or loved one with dementia in their beds.
Although this may sound like a good idea, it really isnt. You could erode trust in your relationship with the dementia patient, which will make caring for them in the future much more difficult.
Instead, what many caretakers do is lift the height of the bed rails in the persons bed. Raising the safety rails doesnt make it impossible for them to leave their bed, but it certainly does make it more difficult!
Fda Approves Insomnia Drug Suvorexant For Alzheimers Patients
Whether its sleeping too much or experiencing fragmented sleep, people with Alzheimers or other types of dementia may often experience disruptions in their circadian rhythms. Now, a new insomnia drug is available for Alzheimers patients to help smooth out sleep difficulties.
The Food & Drug Administration approved Belsomra, an insomnia drug developed by Merck, for use among Alzheimers patients, the company announced this week. Belsomra is also known by its generic name, suvorexant.
In a study published this month in Alzheimers & Dementia, researchers investigated suvorexants potential in treating insomnia among patients who had mild-to-moderate Alzheimers disease. The study focused on 285 participants and found that suvorexant improved their total sleep time, or TST.
Given the latest findings, the FDA approved an updated label on Belsomra to include treatment for Alzheimers-related insomnia.
Alzheimers disease is often accompanied by disruptions to an individuals sleep-wake patterns and overall difficulty sleeping, Dr. Joseph Herring, associate vice president of Global Clinical Research, Neuroscience at Merck Research Laboratories, said in the companys news release.
Were pleased that the prescribing information for BELSOMRA now includes findings from Mercks first dedicated study of an insomnia medication in patients with mild-to-moderate Alzheimers disease, Herring continued.
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A Sleeping Pill To Slow Alzheimers And Addiction
- A sleeping pill to slow Alzheimers and addiction?
What does sleep have to do with Alzheimers disease, and addiction? We all know how important a good nights sleep is for us to feel rested and energetic for the day ahead, but evidence is building that sleep is integral to many other brain functions.
While we might feel weve had a great nights sleep, our brain has been beavering away, clearing out the cellular rubbish accumulated during the days hard work and pruning back the unneeded synaptic branches created during each and every interaction.
Dr Laura Jacobson heads the Floreys sleep and cognition laboratory, and is fascinated by the extensive role sleep plays in keeping us healthy, and how disordered sleep may in fact be a contributor, not just a symptom, of many brain diseases, including dementia and post-traumatic stress disorder.
Alzheimers and fronto-temporal dementia are characterised by abnormal build-ups of two proteins, amyloid and tau. These clumps of protein then cause brain cells to die.
Laura is particularly interested in two forms of dementia, Alzheimers disease and fronto-temporal dementia. Sleep disturbances are one of the earliest symptoms of Alzheimers, even before memory problems begin, although the underlying reasons for this are still unknown.
Medications For Sundown Syndrome
There are several medications used in the treatment of sundowning including melatonin, antipsychotics, antidepressants, benzodiazepines, and cannabinoids. While commonly used, there is little evidence to suggest benefits associated with the use of benzodiazepines and cannabinoids, and due to the significant negative side effects associated, the use of these agents should be avoided. Antipsychotics are commonly used and are recommended as possible treatments in national guidelines, yet there are only limited data that show minimal benefits for these patients. There have been few double-blind, randomized controlled trials evaluating the use of exogenous melatonin. Overall, these studies show some behavioral improvement with extended use. Melatonin dosage widely varied in these studies between 1.5 mg and 10 mg. Several non-pharmacological strategies have been used and have shown to have some beneficial impact on circadian rhythm and possibly nighttime behavioral disturbances in patients with dementia including physical exercise, aromatherapy, music therapy, and bright light therapy. Three treatment principles are suggested when considering treatments for sundown syndrome: the treatment process is a trial-and-error approach, start with lower dosages and slowly titrate upwards, and multi-component therapy may be indicated. Further investigation of non-pharmacological and pharmacological-targeted strategies would be of benefit.
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No Easy Solutions But Improvement Is Usually Possible
As many of you know, behavior problems are difficult in dementia in large part because there is usually no easy way to fix them.
Many probably too many older adults with Alzheimers and other dementias are being medicated for their behavior problems.
If your family is struggling with behavior problems, I know that reading this article will not quickly solve them.
But I hope this information will enable you to make more informed decisions. This way youll help ensure that any medications are used thoughtfully, in the lowest doses necessary, and in combination with non-drug dementia behavior management approaches.
To learn about non-drug management approaches, I recommend this article: 7 Steps to Managing Difficult Dementia Behaviors
And if you are looking for a memory care facility, try to find out how many of their residents are being medicated for behavior. For people with Alzheimers and other dementias, its best to be cared for by people who dont turn first to chemical restraints such as antipsychotics and benzodiazepines.
This article was first published in 2016, and was last updated by Dr. K in May 2022.
What Can I Do To Help My Dad With Dementia Sleep Better At Night He Suffers From Sundowning And Often Won’t Sleep Until Extremely Late
From late afternoon its important to remain calm and stick to the bedtime routine, as your dad may pick up on your stress causing him distress. Try to find a balance between your dad not being over-tired while still being tired enough for bed. This might mean experimenting with naptimes. Natural daylight is wonderful for helping to reset a disrupted body-clock, so you should consider simply sitting outdoors or next to a bright window when your dad starts to show signs of agitation or restlessness. Find more tips on how to deal with Sundowning here.
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How To Keep Dementia Patients In Bed At Night
Dementia affects everything, including sleeping patterns. You may be able to sleep at night, but your live-in parent or loved one with dementia unfortunately may not. If theyve taken to night wandering, youll worry they might turn the stove on or even try to leave the house, which means you might have a hard time getting enough sleep, as well.
How do you keep family members with dementia or Alzheimers disease from getting out of bed so you both get a better nights sleep?
Tips to keep dementia and Alzheimers patients in bed at night include:
- Keep the person hydrated and well-fed
- No caffeine in the late afternoon or early evening
- Make a bedtime routine
- Be active and get regular exercise together
- Get physical and mental conditions treated
- Check their medications
- Make the room comfortable
When you cant get restful sleep at night, that makes you a poor caretaker for your parent or loved one with dementia. Yet when theyre the reason you cant sleep, the matter becomes more complex still.
Keep reading for more information to get your loved one with dementia to stay in bed.