Sleep problems are often experienced by people with Alzheimer’s disease or dementia. It is not entirely clear why this is such a common issue with Alzheimer’s disease and dementia, but scientists believe that, along with memory and behavior changes, the impact of Alzheimer’s on the brain can also affect sleep. This may result in less time in deep sleep and more time awake at night. Additional difficulties may include excessive sleepiness or agitation during the day and abnormal movements or breathing during sleep.
Some factors that may be affecting healthy sleep can readily be identified.
Certain Medical Conditions and Medications: Some people with Alzheimer’s or dementia may also have additional health problems that can impact sleep, including breathing difficulties, chronic pain or overactive bladders which can lead to frequent nighttime urination. Additionally, some medications for conditions commonly experienced by older adults – such as arthritis, heart or lung conditions, or gastroesophageal reflux, for example – may have side effects which contribute to disturbed sleep.
Increased Sleep Disorders in Older Adults: Sleep-related breathing disorders are found to be more common in older adults. Conditions such as sleep apnea and other related syndromes may affect up to 50 percent of seniors.
Use of Sleep Medications: It may seem logical to use sleeping pills or sedatives to address sleep issues, but this could worsen the problem in some cases. If the dementia patient feels too sedated during the day, they may sleep or nap too much then have difficulty sleeping at night. Additionally, stronger sedatives and tranquilizing medications have been shown to have side effects in people with dementia such as increased risks of falling and worsening sleep cognition. However, if the patient’s doctor feels a mild sedative might be beneficial, a low dose sedative or melatonin option might be used effectively.
So if sleep medications are not necessarily the answer, how can we help people with Alzheimer’s and dementia experience fuller and more restful sleep? Some straightforward, non-drug approaches have been shown to effectively improve nighttime sleep for many dementia sufferers:
Increase physical activity during the day. Walking or keeping active during the day can help people with Alzheimer’s and dementia sleep better at night.
Avoid overstimulation close to bedtime. Too much stimulation late in the day could lead to disrupted sleep. This could include too much activity or having a large meal close to bedtime, as well as consumption of alcohol, caffeine or sugar at the end of the day.
Keep a regular routine. A consistent daytime routine, including regular wake up times, mealtimes and bedtimes, can help establish familiar cues and a sense of routine.
Improve daytime light exposure. If the patient is unable to get outdoors to experience natural light during the day, special bright light therapy lamps can be used indoors to ensure consistent exposure to light during the day.
Optimize sleeping environment. Make sure the sleeping environment feels safe and comfortable. It should be quiet and dark and maintained at a comfortable temperature. Additional safety measures may include nightlights, keeping windows locked, and using sensors or motion detectors.
While these non-drug approaches are recommended as the first steps to dealing with sleep issues experienced by people with Alzheimer’s and dementia, you can discuss with the patient’s doctor the possible benefits or risks of including any medications to help relieve sleep disturbances as well.
Keeping a sleep journal to track both sleep and daily activity can help Alzheimer’s patients and their caregivers better understand what environmental triggers may be contributing to sleep disturbances. Addressing these triggers with non-drug remedies, such as increasing sunlight exposure or walking more frequently can help improve both quality of life and sleep experiences. Of course, caregivers must also take care of their own quality of life needs as well by getting plenty of restful sleep themselves.