As most of us will have experienced at one time or another, not being able to sleep, or not sleeping well can become literally a nightmare. For those living with dementia not getting a good night’s sleep can be particularly acute and really affect their quality of life, and those caring for them.
This guide explains how to help dementia patients sleep. You can also find out more about common sleep problems encountered, get tips on how to keep dementia patients in bed at night and read our FAQs:
- Why Do People With Dementia Have Trouble Sleeping?
- How To Help Dementia Patients Sleep Better
- Spotting Common Dementia and Sleep Problems
- Sleep Aids For People With Dementia
- Frequently Asked Questions About Dementia Sleep Problems
Why dementia patients don’t sleep well
Depending on the stage of dementia the sleep pattern can change from sleeping too little to sleeping too much. As dementia progresses it is not unusual for the pattern to deteriorate. Below, we have outlined the surrounding issues of sleep and dementia and hence why dementia patients don’t sleep well.
Changes in the brain
The disruption to the body’s circadian rhythm (more commonly known as our body clock) means the alignment to the 24-hour day is off balance, which impacts the sleep-wake cycle. This mix-up will make it harder for people with dementia to realise whether it is night or day.
Some drugs used to treat dementia can cause night time stimulation and dream disturbances.
Light disturbance in a sleeping area during the night-time can cause confusion as to whether it is night or day, and can cause night-time wandering.
Specific types of dementia
All forms of dementia can cause sleep problems. Sleep disturbances are particularly common with Lewy-body dementia and Parkinson’s disease dementia due to the physical changes to the brain and the association with REM sleep behaviour disorder. We’ve detailed the different types of dementia for you.
Waking up from a dream can be confusing and distinguishing between the dream and reality becomes difficult.
Pain within the body, particularly pain in joints, is a part of advanced ageing, so it’s no surprise that older patients with dementia experience uncomfortable nocturnal sleep disorders.
Napping during the day
Frequent naps in the day time, especially when taken lying in a bed, will result in a lack of sleep during the night.
How to help dementia patients sleep better
Although night times can prove difficult for those with dementia, there are certain things you can do to help. Here are 12 ways to encourage a better sleep pattern:
1. 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 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 will wake someone up, and can be really frightening for the person sleeping next to them – waiting for them to breathe.
If your parent 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 wake you up. If you discover that your parent has either of these medical conditions, it’s wise to see a GP and ask for help.
2. Get the lighting right
To aid a more restful night’s 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 to readjust the body clock.
Consider 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.
Shop motion sensor night lights at Amazon from £8.99.
3. Review any medication being taken
The side-effects of some dementia drugs may not promote a restful sleep, so chat to your parent’s doctor about the optimum time of day to take them. Don’t be tempted to give sleeping pills to someone with dementia, as hypnotics or sedatives can exacerbate confusion.
We’ve detailed the medications used in the treatment of dementia to help you understand the different types.
4. Keep the patient active during the day
Plan daily activities; go for a stroll outdoors, meet family members and friends, and if they’re up for it, join an appropriate club or society. Exposure to natural daylight is important to regulate the body clock, and getting out and about is the best way to enjoy physical health.
5. Get into a good routine
Your parent may find it difficult to remember new routines so it’s best to try a daily schedule to provide comfort and familiarity. Introducing new routines will only add unnecessary stress, anger and confusion. Associating activities with bed time will encourage better sleeping habits; this can include a bath, playing music, brushing their teeth, hot milky drink or even the scent of lavender on a pillow from a scented spray.
A scented pillow spray presents a sleep solution to help overcome restlessness or trouble drifting off. The smell of the lavender blend naturally encourages sleep. This is particularly helpful to those in the later stages of dementia when it is common for patients to respond to the sense of smell.
Shop scented pillow sprays at John Lewis from £27.50.
6. Avoid alcohol or caffeine products from late afternoon
Avoid drinking tea or coffee from late afternoon and take care with other foods too which may be hiding stimulants. Some fizzy drinks and even chocolate may have enough caffeine to keep your parent awake.
7. Drink plenty of fluids throughout the day
It is very important that people with dementia stay hydrated. Dehydration can cause added confusion and illnesses such as urinary tract infections. It is best to encourage consumption of most daily fluids in the early and middle hours of the day to avoid getting up for the bathroom in the night. If the person you care for enjoys an evening cup of tea, try decaf to avoid caffeine before bed.
8. Adjust eating patterns
It’s difficult to fall asleep after a large meal, especially if the food contains a large amount of sugar. Limit the intake of food in an evening to a healthy snack or light meal. If mealtimes are becoming a problem full stop, we have a guide to offer practical tips to help someone with dementia eat more.
9. Make napping in the day part of the routine
Planning activities before and after a nap will encourage a regular wake-up time; ultimately you want your parent to be tired for bed later. Make it a routine to nap in a chair and not in a bed to encourage lighter sleeping.
10. Stop confusion over time
Place a clock next to your parent’s bed to show them whether it is day or night. There are lots of clocks available specifically for people living with dementia. You can find some of them at Live Better with Dementia.
11. Comfort them should they wake in the night
If your parent gets up in the middle of the night, try to establish the cause for waking. Sit and talk with them for a while quietly in low light. Keep them relaxed and repeat actions they associate with bed time such as soft music until they are ready to return to their bedroom.
A wireless bed exit pad and alarm can help alert you if someone with dementia awakens. This means you can keep a check on someone with dementia if they are prone to wandering in the night. A motion sensor pad is placed on the mattress. As soon as someone gets out of bed, a wireless signal is sent to the alarm which can be up to 90 metres away. If the person with dementia rolls over in bed, the system will not sound, it is only when their weight completely. This means movement can be monitored throughout the night from a distance and without the person with dementia being flustered by an alarm in their own room.
Shop wireless bed exit pad and alarm at Amazon from £98.95.
12. And finally, do everything you can to promote relaxation
Create a restful environment in the evening and stick to a night-time routine. During mid-stage to advanced dementia there is advice that suggests someone with dementia shouldn’t watch TV or read a book as they can find this difficult and become frustrated; playing soft music may be a better alternative. The bedroom should be comfortable, not too hot, not too cold and with cosy bedding.
We also have a guide for the elderly on how to get a better night’s sleep, you might find some of these tips useful too.
Spotting common dementia and sleep problems
Keeping a diary to monitor your parent’s sleeping pattern, food and drink intake and medication timetable will help identify if they are getting enough sleep and if there is another reason why they don’t sleep well. Here are some common dementia and sleep problems to look for and make a note of:
- Excessive sleeping
- Not sleeping a lot and difficulty in falling asleep
- Constantly waking throughout the night
- Night-time wandering and disorientation
- Hard to stay awake during the day and taking frequent naps
- Sundowning, sometimes referred to as ‘late-day confusion’.
Sundowner’s syndrome is a dementia-related disorder where a person with dementia becomes increasingly anxious and unsettled in the late afternoons and evenings, compared to their behaviour earlier in the day. Sundowning is more often experienced with mid-stage to advanced dementia.
Caring for a patient with dementia and sleep problems is hard work. When the dementia patient is not sleeping at all it is easy to become exhausted. To give the best care, the carer needs to look after themselves.
We’ve some advice on how to remain positive when caring for someone with dementia.
Sleep aids for dementia patients
Sleep inducing medications can cause concerning side effects in dementia patients not sleeping. These include worsened cognition and an increased risk of falling. Therefore, recommended sleep aids for dementia are non-drug based and aim to improve sleep routine and the sleeping environment. Below, we round up four sleep remedies that can help induce better sleep.
A weighted blanket has been scientifically proven to reduce anxiety and agitation late at night for a dementia patient not sleeping. The gentle pressure from the blanket stimulates the body to produce serotonin. This can help promote calm and deep sleep.
Shop weighted blankets at John Lewis from £60.
Glowing timer device
A glowing timer device uses a light pattern system and metronome. It helps people with dementia concentrate on slowing their breathing, helping them to fall asleep naturally more quickly. The light exercise lasts eight to 20 minutes then switches itself off.
Shop glowing timer device ‘Dodow’ at Amazon from £50.
Sleep aid nutrients
Nutrients at night-time such as melatonin make for a deeper and better quality night’s sleep. Such nutrients can also help ensure a person with dementia is receiving vitamins as sometimes eating a balanced diet can prove problematic.
Shop advanced nutrients sleep aid at Amazon from £22.
Frequently asked questions about dementia sleep problems
Yes, there are. These residential units will allow your dad to live in a home environment with the benefit of trained staff on hand to help care for him.It may also be worth considering finding a care home in the right location to enable friends and family to visit regularly. This may be more fitting for you dad and ease the transition.
Patients with dementia, and sleeping a lot during the day, don’t sleep well at night. Understandably, you might find it hard to disturb her.Being awake during the night drastically limits the physical activities your mum can take part in during the day which can lead to ill health in other ways. A healthy day-time routine which involves outdoor activities will encourage her to sleep during the night. But, if she needs to rest, then scheduling in short naps in a relaxing chair throughout the day will help.
To keep someone with dementia in bed may not be the best thing to do. According to the Alzheimer’s 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, don’t try to get them back to bed, instead start a simple task with them or quietly read a book with them.
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 ‘hangover’ effect that sleeping medication leaves a person with in a morning can exacerbate the patient’s confusion, anger and irritability. Try promoting better sleep strategies and sleep aids for dementia above before using medication. 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 may be used for short period of time – but always talk to a GP first – they’re used to being asked how to get dementia patients to sleep at night.
Firstly, you may need to look at your parent’s 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. Putting labels on doors and items is also a good idea to prevent added stress and confusion. A simple photo of the toilet on the toilet door will help direct them to the ‘little room’, together with the installation of a little plug-in nightlight. But, if you feel you will still worry, then place a monitor in their room to alert you should they start moving.
From late afternoon it’s important to remain calm, as your dad may pick up on your stress causing him distress. Keep to a daily routine and ensure your dad doesn’t get over-tired. 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.