Not sleeping can put a real downer on your day, and have a negative impact on Dementia Patients – which is the last thing they need!
There are many reasons why people with dementia have trouble sleeping.
In this article we explore what causes these irregular sleep patterns and what steps can be taken for a better night’s sleep.
Why do people with dementia have trouble sleeping?
Sleep disorders are common for people with dementia. There may be a tendency to sleep during the day and to wake frequently during the night. Scientists are not completely sure why the changes to the brain associated with dementia impact on sleep.
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.
Irregular sleep patterns affect the quality of life for the person with dementia, and effects the wellbeing of those around them, in particularly those who are caring for them.
As care for the person with dementia can be challenging and unpredictable, it’s important to understand the condition and to establish coping mechanisms.
Supporting a parent with dementia who has trouble sleeping
Behaviour can worsen when your parent gets little sleep resulting in increased irritability and emotional instability. Unsurprisingly, these out-of-
character behaviours can heighten tensions between you both, as you too will be tired.
It’s important to look past behaviours and consider what the causes may be.
We’ve an article on understanding dementia to guide you through what dementia is, and how to find extra resources. You’ll find this a great help if you are at the early stages of caring for someone with dementia.
Dementia Sleep Disorders
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 sleep disorders 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 parent with dementia can be quite frightening; our article on Dementia Elderly Care Options & Caring for People with Dementia will provide you with more information.
Let’s look at 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.
Medication. Some drugs used to treat dementia can cause night time stimulation and dream disturbances.
Light. 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.
Dreaming. Waking up from a dream can be confusing and distinguishing between the dream and reality becomes difficult.
Untreated pain. 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 your parent sleep better
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 theybreathe, almost looking like they have momentarily stopped breathing, due to an obstruction in the throat or nose. This momentary lack of air will wake your parent.
- If your parent suffers from restless leg syndrome no doubt they have mentioned it to you, or you’ve noticed that 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. Even though the symptoms can be relieved by rubbing and stretching their legs, your parent will have already woken.
If you discover that your parent has either of these medical conditions, it’s wise to see a GP and ask for help.
2. Alleviate any pain
Watch for changes to your parent’s movements and ask them if they feel any pain. Even if it seems something little, ask a GP to check it out as the slightest discomfort can result in sleep deprivation.
3. 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.
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.
5. 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. We’ve some ideas on suitable daytime activities you might like.
6. Get into a good routine.
Your parent may find it difficult to remember new routines so it’s best to stick to 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.
7. Do not give 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.
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 your parent’s 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, as lying down produces a deeper, more excessive sleep.
10. Stop confusion over time
Place a clock next to your parent’s bed to show them whether it is day or night.
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.
12. And finally, do everything you can to promote relaxation
Create a restful environment in the evening and stick to your parent’s night-time routine. During mid-stage to advanced dementia it is not recommended that someone with dementia watch TV or read a book as they can find this difficult and become frustrated; playing soft music is a much better alternative. Your parent’s sleeping area should be comfortable, not too hot, not too cold and with cosy bedding. Remove any objects that could be a trip-hazard too.
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.
Care for the carer
Caring for a patient with dementia is hard work and when the patient experiences irregular sleep patterns 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.
- Got a question about NHS Funded care? Go to our forum now!
- The NHS website provides details on activities for people with dementia, including multisensory activities, memory cafes and ‘singing for the brain’
- There’s more information on dementia and care homes on the NHS website
- As a carer for someone with dementia, you are not alone. Seek out information and resources available from the Alzheimer’s Association
- Visit SADA, a UK registered charity, who can advise on light and light therapy.
- To read more information on sundowning, visit Dementia UK.
Dementia & Sleep: Questions and Answers
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.
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.
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 help dementia patients sleep.
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.
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.