As we’ve discussed before in these pages, dementia and sleep have a bit of a “chicken-and-egg” relationship: people with dementia tend to experience sleep issues, and people with certain types of sleep disorders have a greater instance of developing dementia. Add to that the fact that certain aspects of dementia (like medication side-effects) can also cause sleep disturbance, further complicating the diagnostic process. There’s clearly more research to be done to unravel these threads. But regarding the practical matter of dealing with sleep issues that result from dementia, doctors have been able to identify certain approaches that can help mitigate symptoms whether at home or in the context of memory care facilities.
First, let’s review what sleep issues are most commonly associated with dementia. These include:
- Insomnia – trouble both falling asleep and staying asleep
- Hyperinsomnia – excessive daytime sleepiness, or the inability to stay awake and alert during normal waking hours
- Nighttime hallucinations or other parasomnia disorders that cause involuntary emotional or physical reactions during sleep
- Nighttime behavioral issues that disrupt sleep, such as sleep walking and bedwetting
- Breathing problems like sleep apnea (the most common); people with moderate-to-severe Alzheimer’s, for example, experience as many as five respiratory events per hour of sleep.
- Excessive nighttime activity such as restless legs syndrome or RLS
Most elderly people experience changes in circadian rhythms as they age. With dementia patients – specifically those suffering from Alzheimer’s – brain degeneration associated with the disease causes damage to that part of the brain which regulates sleep patterns. There’s also the factor of amyloid plaque build-up, a hallmark of Alzheimer’s, which is known to cause sleep disorders.
So what do doctors recommend to help mitigate these issues? Since medications that help with sleep also carry cognitive side-effects, experts tend to steer toward behavioral modifications as more effective ways to address the problem. These include:
- Maintaining a consistent sleep schedule: Because circadian rhythm is a huge factor in treatment, doctors encourage getting to sleep and waking up the same time each day. This may involve setting alarms and making extra effort to work against the body’s desire for sleep at odd times. In memory care facilities, you may be able to arrange that staff wake you in person.
- Creating a healthy sleep space: All of us are encouraged to power down and make bedtime exclusively rest time; this is especially true for dementia sufferers. Discourage watching TV or eating in bed, and keep the room dim and quiet.
- Getting enough exercise: While dementia patients often have more limited mobility, even the most basic movement like taking a 15-minute walk three times a day will help promote wakeful hours.
- Prioritizing diet: Along with sticking to a nutritious diet, dementia sufferers can supplement what they eat with foods that encourage sleep. Calcium-rich foods like milk and cheese encourage melatonin production, while hearty grains like brown rice and oatmeal elevate blood sugar and promote sleepiness. Stimulants to avoid include excessive caffeine, alcohol, and sugar.
- Seeking sun exposure and light therapy: Getting out in the sunlight helps regulate our circadian rhythms; make sure Mom breaks up her indoor rest time with some trips outside at least three times a day. Light therapy (timed exposure to artificial light sources) has also been shown to help with the body’s ability to regulate sleep cycles.
More for information on dementia-related sleep disorders, head to the National Sleep Foundation. And if you’re wondering whether staying at home or a move to senior living and memory care facilities is your best bet, our solutions guide helps explain what your options are. Check it out by clicking the link below.