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What Can You Give Dementia Patients To Help Them Sleep

Get The Lighting Right

How to improve sleep in dementia

To aid a more restful nights sleep the bedroom should be as comfortable as possible. Using blackout curtains are a good idea during night-time to eliminate outside disturbances. Research suggests that light therapy can reduce restlessness and confusion for people with dementia. Should you wish to consider light therapy, it has been proven that violet coloured light promotes drowsiness and a full-spectrum fluorescent light used for the first two hours of the day can be settling. Light therapy that follows a regular pattern can also help with disturbed body clocks.

Safety – if night wandering is a problem, or frequent visits to the loo, you will need to consider some sort of low light to prevent your parent falling in the dark. You may want to invest in a motion sensor night light. A motion sensor light automatically turns on when motion is detected within three metres. It then turns off after 30 seconds of no activity. This means that people with dementia can use the bathroom in the night or get out of bed with less risk of falling. The light is gentle and warm in order to not interrupt sleep.

  • Hard to stay awake during the day and taking frequent naps
  • Sundowning, sometimes referred to as late-day confusion.

Sundowning is a dementia-related disorder where a person becomes increasingly anxious and unsettled in the late afternoons and evenings. Sundowning is more often experienced with mid-stage to advanced dementia.

Medicines For Sleep Problems In Dementia

Background

People with dementia frequently experience sleep disturbances. These can include reduced sleep at night, frequent wakening, wandering at night, and sleeping excessively during the day.

These behaviours cause a lot of stress to carers, and may be associated with earlier admission to institutional care for people with dementia. They can also be difficult for care-home staff to manage.

Non-drug approaches to treatment should be tried first, However, these may not help and medicines are often used. Since the source of the sleep problems may be changes in the brain caused by dementia, it is not clear whether normal sleeping tablets are effective for people with dementia, and there are worries that the medicines could cause significant side effects .

The purpose of this review

In this updated Cochrane review, we tried to identify the benefits and common harms of any medicine used to treat sleep problems in people with dementia.

Findings of this review

We searched up to February 2020 for well-designed trials that compared any medicine used for treating sleep problems in people with dementia with a fake medicine . We consulted a panel of carers to help us identify the most important outcomes to look for in the trials.

Participants in the trazodone trial and most of those in the melatonin trials had moderate-to-severe dementia, while those in the ramelteon and orexin antagonist trials had mild-to-moderate dementia.

Shortcomings of this review

How Do You Make A Dementia Patient Happy

If a person with dementia gets suitable surroundings, they can lead productive, satisfying, and most importantly, happy lives for many years after the initial diagnosis. The happier they are the less likely they are to get angry or start exhibiting worrisome behavior. Here are some effective tips for making a dementia patient happy:

  • Providing emotional support and a relaxed environment
  • Helping the person feel safe and comfortable
  • Spending time talking to them and relaxing with them
  • Adding fun activities
  • Adding meaningful activities

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Ten Tips For Communicating With A Person With Dementia

We arenât born knowing how to communicate with a person with dementiaâbut we can learn. Improving your communication skills will help make caregiving less stressful and will likely improve the quality of your relationship with your loved one. Good communication skills will also enhance your ability to handle the difficult behavior you may encounter as you care for a person with a dementing illness.

  • Set a positive mood for interaction. Your attitude and body language communicate your feelings and thoughts more strongly than your words do. Set a positive mood by speaking to your loved one in a pleasant and respectful manner. Use facial expressions, tone of voice, and physical touch to help convey your message and show your feelings of affection.
  • Get the personâs attention. Limit distractions and noiseâturn off the radio or TV, close the curtains or shut the door, or move to quieter surroundings. Before speaking, make sure you have her attention address her by name, identify yourself by name and relation, and use nonverbal cues and touch to help keep her focused. If she is seated, get down to her level and maintain eye contact.
  • Listen with your ears, eyes, and heart. Be patient in waiting for your loved oneâs reply. If she is struggling for an answer, itâs okay to suggest words. Watch for nonverbal cues and body language, and respond appropriately. Always strive to listen for the meaning and feelings that underlie the words.
  • Planning For When Your Loved One Does Wander

    How to Get Dementia Patients to Sleep at Night

    In case your loved one does wander, its a good idea to have a plan in place.

    • Notify neighbors and local police about your loved ones tendency to wander, and circulate your phone number.
    • Have your loved one wear an ID bracelet or labels in clothing. Digital devices using GPS technology can track your loved ones location.
    • In case a police search becomes necessary, have a recent photo of your loved one and some unwashed clothing to help search-and-rescue dogs.
    • In the U.S., sign up for the Alzheimers Associations Medic Alert and Safe Return Program, an identification system to help rescue lost Alzheimers patients.

    How to find a missing Alzheimers patient

    A person with dementia may not call out for help or answer your calls, even when trapped somewhere, leaving them at risk for dehydration and hypothermia.

    Check dangerous areas near the home, such as bodies of water, dense foliage, tunnels, bus stops, and high balconies.

    Look within a one-mile radius of where the patient was before wandering.

    Look within one hundred feet of a road, as most wanderers start out on roads and remain close by. Especially look carefully into bushes and ditches, as your loved one may have fallen or become trapped.

    Search in the direction of the wanderers dominant hand. People usually travel first in their dominant direction.

    Investigate familiar places, such as former residences or favorite spots. Often, wandering has a particular destination.

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    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?
  • Sleep Aids And Dementia: Studies Find Both Risks And Benefits

    REPORTING FROM AAIC 2019

    LOS ANGELES While a large number of older adults take prescription and nonprescription medications to help them sleep, the effect of these medications on dementia risk is unclear, with most researchers advocating a cautious and conservative approach to prescribing.

    Research is increasingly revealing a bidirectional relationship between sleep and dementia. Poor sleep especially from insomnia, sleep deprivation, or obstructive sleep apnea is known to increase dementia risk. Dementias, meanwhile, are associated with serious circadian rhythm disturbances, leading to nighttime sleep loss and increasing the likelihood of institutionalization.

    At the Alzheimers Association International Conference, researchers presented findings assessing the links between sleep medication use and dementia and also what agents or approaches might safely improve sleep in people with sleep disorders who are at risk for dementia or who have been diagnosed with dementia.

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    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.

    Sleep Medications Affect Certain Races Differently

    Caregiver Training: Sleep Disturbances | UCLA Alzheimer’s and Dementia Care Program

    Researchers at the University of California, San Francisco studied white and African American adults between ages 7079 who were not living with dementia at the start of the study. The researchers followed participants for 15 years and found that participants who said they took sleep medications often or almost always were more likely to develop dementia than those who said they never or rarely took sleep medications. However, the team only found an increased dementia risk among white males who commonly took sleep medications.

    Based on our findings, we recommend that clinicians make more effort to be aware of their patients sleep problems including use of sleep aids, said lead study author Yue Leng, PhD, University of California, San Francisco. In particular, clinicians may need to be more cautious about prescribing sleep medications to older adults who are at high risk for dementia. There are non-pharmacological sleep treatment options that should be considered.

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    Create A Calm And Soothing Environment

    The environment and atmosphere you create while caregiving can play a large part in helping an Alzheimers or dementia patient feel calm and safe.

    Modify the environment to reduce potential stressors that can create agitation and disorientation. These include loud or unidentifiable noises, shadowy lighting, mirrors or other reflecting surfaces, garish colors, and patterned wallpaper.

    Maintain calm within yourself. Getting anxious or upset in response to problem behavior can increase the patients stress. Respond to the emotion being communicated by the behavior, not the behavior itself. Try to remain flexible, patient, and relaxed. If you find yourself becoming anxious or losing control, take time out to cool down.

    What Calms A Dementia Patient

    You can use calming phrases such as: Youre safe here Im sorry that youre upset and Ill stay until you feel better.. Let the person know that you are there by letting them know. Activities should be conducted with the person. Engaging the person through art, music, or other activities can help distract them from the anxiety and help them relax.

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    Dealing With Dementia Behavior: Wandering

    Two characteristic precursors to wandering are restlessness and disorientation. An Alzheimers patient may exhibit signs of restlessness when hungry, thirsty, constipated, or in pain. They may also become disoriented, pace, or wander when bored, anxious or stressed due to an uncomfortable environment or lack of exercise. As well as adding physical activity to your loved ones daily routine, you can:

    • Immediately redirect pacing or restless behavior into productive activity or exercise.
    • Reassure the person if they appear disoriented.
    • Distract the person with another activity at the time of day when wandering most often occurs.
    • Reduce noise levels and confusion. Turn off the TV or radio, close the curtains, or move the patient to quieter surroundings.
    • Consult the doctor as disorientation can also be a result of medication side effects, drug interactions, or over-medicating.

    Can Someone With Dementia Take Melatonin

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    It is generally safe to take melatonin supplements as they are used to treat insomnia. It is possible that they may modestly improve sleep, which may eventually lead to a reduction in Alzheimers risk. melatonin is not recommended for elderly people with dementia because other insomnia treatments may be more effective.

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    Could I Use Sleeping Tablets For A Limited Time Just To Help The Person I Care For With Dementia Get Back Into A Routine Of Sleeping Throughout The Night

    However tempting this may be, the use of sleeping pills for dementia patients can be just too dangerous as they are at risk of falling. The morning hangover effect that sleeping medication leaves a person with can exacerbate the dementia patient’s symptoms of confusion, anger and irritability. Try promoting better sleep strategies and sleep aids for dementia instead. If the person with dementia constantly wakes and gets up, and is at high risk of falling, then a doctor may decide that sleeping pills for a dementia patient can be used for short period of time. Always talk to a GP first as they are used to being asked how to get dementia patients to sleep at night.

    Stage : Moderate Dementia

    Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.

    While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.

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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.

    Do Sleep Medications Increase Dementia Risk

    Sleep Issues and Dementia

    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.

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    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.

    Final Thoughts On Using Cbd Oil For Dementia

    Dementia is a severe neurodegenerative condition. Its not a disease per se instead, its a set of symptoms that describe a predictable set of symptoms. It can take many forms, from Alzheimers Disease to vascular dementia and Lewy Bodies Dementia. Dementia can also result from the progress of other neurodegenerative diseases, such as Parkinsons or Huntingtons Disease.

    Scientists have been investigating the neuroprotectant properties of CBD and its influence on neurodegeneration for quite some time now. While the evidence isnt conclusive yet, results from animal studies and preclinical trials indicate that the endocannabinoid system and cannabinoids can be used to prevent neurodegeneration and reverse its impact with consistent administration.

    If youre interested in trying CBD oil for dementia, make sure to contact your doctor first to figure out whether CBD is good for you, especially if youre already using some medication.

    References:

  • Prenderville, J. A., Kelly, Á. M., & Downer, E. J. . The Role of Cannabinoids in Adult Neurogenesis. British Journal of Pharmacology, 172, 39503963.
  • Walther, S., & Halpern, M. . Cannabinoids and Dementia: A Review of Clinical and Preclinical Data. Pharmaceuticals , 3, 26892708.
  • Karl, T., Cheng, D., Garner, B., Arnold, J.C. . The Therapeutic Potential of the Endocannabinoid System for Alzheimers Disease. Expert Opinion on Therapeutic Targets, 16, 407420.
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