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Why Do Dementia Patients Not Sleep

What You Can Do For Your Loved One

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

As an individual with dementia declines, you can help them by providing a loving and supportive presence. Sit with them. Hold their hand. Play music they enjoy.

One of the greatest gifts you can give your loved one is helping to get their affairs in order. Ensure that financial and healthcare powers of attorney are put in place, so you can make decisions when your loved one is no longer able. Look into funeral arrangements before you need them, so you dont need to make important decisions in a time of crisis.

Talk to your loved ones physician about the possibility of palliative care support in the home and hospice care when your loved one is ready.

Stage : Mild Cognitive Impairment

Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:

  • Getting lost easily
  • Noticeably poor performance at work
  • Forgetting the names of family members and close friends
  • Difficulty retaining information read in a book or passage
  • Losing or misplacing important objects
  • Difficulty concentrating

Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

Alzheimers And Sleep Disorders: Expert Answers To 6 Common Questions

Sleep issues are a well-documented symptom of many types of dementia, particularly Alzheimers disease. This presents a serious challenge for families. If a loved one with dementia isnt sleeping, then neither is their caregiver.

Quite often, the lack of sleep is what first causes a family caregiver to consider placing a loved one in a facility, says Maureen Bradley, LPN, Certified Dementia Practitioner, director of Alzheimers care programs at several skilled nursing facilities run by Royal Health Group in New England.

Sleep deprived caregivers are often plagued by many of the same questions about their loved ones odd sleeping habits: How do I get Dad to sleep through the night? Why does my loved one sleep all day? Why does Mom get so anxious around dinner time? Dementia experts provide answers to these and other common questions below.

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Treatment For Sleep Changes And Disturbances In Dementia Patients

Treatment for sleep disturbances in dementia patients depends on their cause. Although sleeping aids can be given to improve sleep, treating the underlying condition can achieve better results.

For example, caregivers can improve the sleeping environment for the patient, ensuring proper temperature and lighting to promote sleep. Patients should also be treated for other medical conditions that may be interfering with their sleep.

It is also important to keep patients on a regular schedule with minimal changes . For example, keep a consistent bedtime, ensure the patients do not sleep throughout the day by keeping them busy, and ensure they are sleeping in the same room night after night.

As a caregiver, you can work with the patients doctor in order to develop a treatment plan that best suits the patient in order to promote sleep.

Mohan Garikiparithi got his degree in medicine from Osmania University . He practiced clinical medicine for over a decade before he shifted his focus to the field of health communications. During his active practice he served as the head of the Dept. of Microbiology in a diagnostic centre in India. On a three-year communications program in Germany, Mohan developed a keen interest in German Medicine , and other alternative systems of medicine. He now advocates treating different medical conditions without the use of traditional drugs. An ardent squash player, Mohan believes in the importance of fitness and wellness.

Sleep Well And Reduce Your Risk Of Dementia And Death

Why Do Dementia Patients Want To Stay In Bed

In a recent blog post I discussed how beneficial sleep is for memory function. But sleep isnt just good for your memory it can actually reduce your risk of dementia and death. Although it has been known for some time that individuals with dementia frequently have poor, fragmented sleep, two new studies suggest that if you dont get enough sleep, you are at increased risk for dementia.

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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.

    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.

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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?
  • Do People With Dementia Sleep A Lot During The Day

    Why is my Person w/ Dementia SLEEPING so much? || The “Why” Series

    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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    Tips For Behavior And Sleep Problems

    Having a daily routine may help. Calmly reassuring and giving cues to orient the person who has dementia is also helpful in the evening and closer to bedtime. Try to keep the person going to bed at the same time every night.

    Calm activities at the end of the day and before bedtime may help the person with dementia sleep better at night. If they are active during the day, these calm activities can make them tired and better able to sleep.

    Avoid loud noises and activity in the home at night, so the person does not wake up once they are asleep.

    Do not restrain a person with dementia when they are in bed. If you are using a hospital bed that has guard rails in the home, putting the rails up may help keep the person from wandering at night.

    Always talk with the person’s health care provider before giving them store-bought sleep medicines. Many sleep aids can make confusion worse.

    If the person with dementia has hallucinations :

    • Try to decrease the stimulation around them. Help them avoid things with bright colors or bold patterns.
    • Make sure there is enough light so that there are no shadows in the room. But do not make rooms so bright that there is a glare.
    • Help them avoid movies or television shows that are violent or action-packed.

    Take the person to places where they can move around and exercise during the day, such as shopping malls.

    Flush Your Brain While You Sleep

    Although it is not totally understood why inadequate sleep increases your dementia risk, one possible reason relates to the deposition of the Alzheimers protein, beta amyloid. Beta amyloid is the protein that clusters and clumps together to form Alzheimers plaques. No one is completely certain what its normal function is, although there is increasing evidence it is involved in the brains defense against invading microorganisms.

    During the day, we all make some of this beta amyloid protein in the brain. When we sleep, however, brain cells and their connections actually shrink. This shrinking allows more space between the brain cells, so that beta amyloid and other substances that accumulate during the day can be flushed away.

    So the theory is, if you dont get enough sleep, your brain wont have enough time to drain away beta amyloid and other substances. These substances then continue to accumulate, day after day, until they cause dementia.

    Also Check: Are Jigsaw Puzzles Good For Dementia

    Tips For Caregivers: Reducing Accidents

    Incontinence often happens due to timing. It may help to recognize potential signs that a person needs to go, such as straining, turning red in the face, and tugging at their clothing. If you help them get dressed, use clothing thats easy to remove such as pants with elastic waistbands instead of buttons and belts.

    One successful technique is prompted voiding. This is a type of bladder retraining that helps people to maintain a regular bathroom schedule. For example, every two hours, ask if theyve had an accident, have the person use the toilet, and praise successes.

    Are There Any Exceptions

    Why Do Dementia Patients Get Angry

    While some dementia patients eat too little, others overeat. Some dementia patients may eat too much food at a time or consume meals too often.

    Its also possible for patients to demonstrate excessive eating and other related eating behavioral changes because of changes in their dietary preferences.

    They may even be obsessed with certain foods.

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    How Changes In The Brain Affect Sleep In Dementia

    The suprachiasmatic nucleus in the hypothalamus of the brain is responsible for controlling our sleep-wake patterns. This is often called a circadian rhythm because these patterns tend to persist at a near-day period.

    With many types of neurodegenerative diseasesincluding dementias such as Alzheimers disease, as well as movement disorders such as Parkinsons diseasecertain areas of the brain may degenerate over time. Brain cells may become less responsive to chemicals called neurotransmitters, or debris may build up disrupting their function. Global brain degeneration, called atrophy, may occur as individual neurons die off. In addition, specific regions of the brain may be lost.

    If the SCN is lost, our ability to maintain a normal sleep-wake pattern will be adversely affected. This may manifest in various circadian rhythm disorders. Often, the elderly will experience advanced sleep phase syndrome. This involves a desire to go to bed and wake up early. This desire to change their sleep schedule may be beyond their control and could represent changes in the brain as it ages.

    Avoid Certain Food And Drink

    Avoid caffeine, alcohol and very spicy foods 4 to 6 hours before bedtime. Caffeine delays our circadian clock. It also impacts the bodys melatonin production. Melatonin is an important chemical required for sleep.

    Increase the amount of and variety of fruits and vegetables in your diet. Research links a diet lacking in variety and sleeping poorly.

    To learn more about a brain healthy diet, read Brain Essential Nutrients and Breakfast and Beyond.

    Recommended Reading: What Is The Difference Between Dementia And Senility

    Stage : Moderately Severe Dementia

    When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:

    • Delusional behavior

    Why Do Dementia Patients Stop Talking

    How to improve sleep in dementia

    There are many signs that can tell you death is near for a dementia payment. Even though you may be prepared for the end, it is never easy. The ten signs that death is near include:

  • Sleeping. The patient may stop responding or may be more sleepy than usual
  • Loss of interest in fluids and food
  • Coolness: the patients legs, feet, arms, hands, ears, and nose may feel cool to touch because of the decrease in circulation
  • Change in the color of the skin because of the low circulation of blood usually called mottling
  • Rattling sounds within the throat and lungs
  • Bowel and bladder changes
  • Changing vital signs
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    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.

    Does Dementia Affect Sleep

    It isn’t uncommon for people with dementia to have trouble sleeping. You may find that it’s harder to fall asleep at night and once you finally do, you may not be able to sleep through the night. Other people with dementia don’t have a problem falling asleep, but they don’t sleep deeply enough to get a good night’s rest. When your sleeping habits are affected by your dementia, you become more prone to confusion and disorientation while you’re awake

    Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.

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    Sleep Disorders And Dementia

    Some common sleep disorders have a tie to dementia.

    Insomnia. When you donât get enough sleep, parts of your brain change. Some of these areas are related to Alzheimerâs disease.

    And research shows youâre more likely to be diagnosed with dementia if you have primary insomnia. Thatâs when your lack of sleep isnât caused by something else, like depression or drug use.

    Your chances of getting Alzheimerâs disease go up if you have primary insomnia and you haven’t reached age 40.

    Obstructed sleep apnea . You may have a higher chance of getting dementia if you have this. Itâs when the muscles in your throat relax when you sleep. If you canât breathe very well at night, your brain canât get enough air. Thatâs called hypoxia. Youâll also have broken sleep if you wake up gasping for breath.

    If you have these things, it could lead to:

    • Problems staying focused
    • Slower motor movements that can affect moves like picking things up and writing
    • Getting dementia at an earlier-than-normal age
    • More serious brain issues
    • Other health conditions, like stroke, diabetes, and high blood pressure

    Circadian rhythm problems. People with dementia may have a shift in their sleep-wake cycle. That means theyâll feel sleepy during the day and awake at night.

    Tips For Managing Dementia End

    What are Wisdom Teeth and Why Do They Need to Be Removed?

    Because individuals with advanced dementia will often have difficulty communicating, it is important that caregivers keep a close eye on their loved one for signs of pain or discomfort. These signs may include moaning or yelling, restlessness or an inability to sleep, grimacing, or sweating. This may also signal that its time to call hospice or a palliative care team to help with the pain management.

    If an individual with end-stage dementia is having trouble sitting up without assistance, hospice can provide a hospital bed or other equipment to lift their head.

    Perhaps the hardest thing for families is when a loved one with dementia is no longer able to eat or swallow. Because an individual with dementia is unable to understand the benefits of feeding tubes or IV drips, they will often be incredibly distressed and attempt to remove them, causing added pain and risk of infection. Instead, focusing on keeping the individual comfortable. Supporting them with mouth care to prevent their mouth from becoming dry will allow them to make their final transition in peace.

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