Dementia and sleep problems

Everyone feels better after a good night’s sleep and people living with dementia are no exception. So what can you do to help them sleep longer and better?

Recognise these problems?

It’s very common for someone with dementia to experience sleep disturbances. This can be extremely difficult and tiring, not just for them but for you too. Some of the most common symptoms include:

-  Difficulty sleeping
-  Frequent waking during the night
-  Night time wandering
-  Daytime napping
Sundowning

Why do they happen?

Changes in the brain
Scientists and researchers are not entirely sure what causes sleep problems in people with Alzheimer’s disease and other dementias, but like many of the other symptoms, it’s most likely down to changes within the brain. This can cause mix-ups in the body’s circadian rhythm (body clock), which can make it harder for people to realise when it’s day and night.

Disorientation after dreaming
Dementia can lead many people to become confused and struggle to distinguish between reality, older memories and even dreams. They may wake from a dream and assume that as it was daytime in their dream, it must be daytime when they’re awake, too.

Less need for sleep
It’s common among older adults for them to need less sleep, or shorter spans of sleep than they did when they were younger, which could cause them to wake more frequently.

Medical problems
Some health issues and medications can affect sleep. These include restless legs syndrome, urinary tract infections, depression and sleep apnoea (an abnormal breathing pattern).

Coping strategies

It’s extremely important that you look into ways of dealing with sleep problems as disturbed sleep can often affect the carer even more than the person with dementia as they cannot get enough sleep and are constantly worrying about what will happen during the night.

Tips to cope with sleep problems

1. Ensure the sleeping area is comfortable. Check the room temperature isn’t too hot or cold, that they have adequate bedding, and that if they do get up, they can see their way to get to the bathroom if needed with night lights.

2. Consider putting blinds or blackout curtains in the room so they can see that it’s dark and don’t need to get up.

3. Put a clear clock near to their bed which shows not just the time, but whether it’s day or night.

4. Watch caffeine and alcohol intake near to bedtime as they can disturb sleep. Large amounts of food, especially sugary meals can also make it harder to fall asleep.

5. Make sure you get out and about with the person with dementia during the day. Exposure to daylight is important for helping to regulate the body clock.

6. Install a bed monitor if you’re worried about night time wandering, which will alert you if they leave the bed or bedroom.

7. Think about your own mental and physical exhaustion. The person you’re caring for may pick up on your stress and this can contribute to sundowning at the end of the day.

8. Relaxation before bed. Try a warm bath, music, putting on night socks and lavender scent on their pillow to help with this.

A word on sleep medication…

It can be tempting to say that all the person with dementia needs is to pop a couple of sleeping pills to help them sleep through the night. However, the risk of giving sleep medication to someone with cognitive difficulties may not be worth it. They’re at increased risk of falls and fractures, confusion and a decline in the ability to care for themselves. It’s definitely worth trying some of the other strategies before looking into sleeping pills, and if they are used, they should only be for a limited amount of time, as advised by their doctor.