Sleep disturbances are relatively common among older adults, but for those with dementia and Alzheimer’s disease, sleep problems are more frequent and severe. Since dementia is a degenerative disease, difficulty sleeping often occurs as the parts of the brain responsible for producing chemicals important for sleep are damaged. Most report these problems in the mid to late stages of dementia.
Carmen Duren, Executive Director at Provident Village at Canton in Canton, GA, understands dementia-related sleep disturbances and how to help residents of their Memory Care neighborhood cope with these issues. Duren states, “People living with dementia can experience problems such as difficulty staying asleep at night, daytime sleepiness and sundowning, a common occurrence with dementia in which the person experiences symptoms of restlessness, confusion or agitation late in the day.
“Sleep is a complex neurological phenomenon, so it can be hard to know exactly what is causing a loved one’s issues. If your loved one has symptoms that disturb their sleep, first discuss possible causes with their doctor. Underlying health conditions or side effects from medications may be the reason.”
Contributing Factors to Sleep Problems
Environmental factors and physical and cognitive changes can trigger behaviors that lead to sundowning and other sleep disturbances. On their webpage “Sleep Issues and Sundowning,” the Alzheimer’s Association describes contributing factors to dementia-related sleep problems, including:
- Exhaustion, either mental or physical
- Disturbance in the person’s internal “body clock”
- Changes in lighting at night, which create shadows and could cause a person to misinterpret their surroundings, becoming afraid or confused
- Picking up on a caregiver’s stress or agitation as they themselves become tired
- Disorientation from the inability to separate dreams from reality at night
- Side effects from medications
- Other health conditions, such as depression, restless leg syndrome or sleep apnea
Depending on which factors tend to cause your loved one’s sleep problems, you can address the issue and find ways to reduce the disturbance it causes. Experts advise trying non-drug solutions before giving your loved one medicinal treatment to help them cope with their sleep problems.
Risks of Pharmacological Treatments
Because the cause of a loved one’s sleep problems may not be determined, taking medication as a treatment could cause more issues. Medicines often prescribed for sleep problems, such as antidepressants or sleeping pills, can have serious side effects in people with dementia. According to the study “Current Treatments for Sleep Disturbances in Individuals with Dementia” done by Cynthia L. Deschenes, MSN, CCRN, and Susan M. McCurry, PhD, the medications most prescribed for sleep issues cause increased daytime sleepiness, confusion, sedation, dizziness and increased cognitive impairment.
If non-drug approaches fail or symptoms are increasingly severe, medication may be necessary as a last resort. Experts suggest that this treatment be given slowly at low doses and, if possible, stopped once a successful sleep schedule is established.
Coping Techniques for Sleeping Problems
If your loved one’s doctor has ruled out health conditions or side effects as the cause of their sleep disturbances, you can try to help your loved one cope by avoiding triggers for sleeplessness. Before turning to medications, try the following techniques to help your loved one enjoy a restful night’s sleep:
- Maintain a steady schedule. As much as possible, have your loved one wake up, go to bed and eat meals at the same times each day. This can help your loved one maintain a consistent internal “clock” that tells their body when it’s time for sleep.
- Plan active days. Schedule appointments and activities in the morning and afternoon so your loved one is less likely to rest all day. Limit daytime napping and encourage daily exercise (at least four hours before bed) to help them sleep more at night.
- Seek sunlight exposure. Help your loved one get outside in the morning, either by going for a walk or gardening. Sunlight and other sources of light therapy can help your loved one associate being awake with daylight.
- Avoid stimulants. Avoid nicotine, alcohol, caffeine and large dinners. Have your loved one’s biggest meal be at noon, and keep dinner simple.
- Adjust the lighting. If your loved one becomes upset due to reduced light and shadows, keep their home well lit at night, installing nightlights in the bedroom and hallways. On the other hand, light can affect our ability to stay asleep. Control the lighting according to your loved one’s symptoms.
- Limit environmental triggers. In the evening hours, try to eliminate the factors that trigger your loved one’s sleep problems or sundowning behaviors, such as watching TV, having visitors, doing chores, loud noises, etc.
- Keep a good sleep environment. Make sure the temperature of your loved one’s bedroom isn’t too hot or too cold. Ensure they are comfortable by treating any pain and making sure they’ve gone to the bathroom before bed. Provide security objects if you can.
Quality Memory Care – Day and Night
“Caring for the variety of symptoms caused by dementia, including sleep problems and sundowning, requires a high level of knowledge about the disease,” says Duren. “That’s why at Provident Village at Canton, we work to help family caregivers learn as much as they can about dementia through special programs and seminars. Caregiver education is consistently part of our community’s schedule of events, available to view on our website.
“We help our residents cope with sleep problems by providing an engaging lifestyle, filled with life-enrichment and social activities to keep them active throughout the day. We also employ a care team specially trained in dementia, so residents’ needs are fully understood and properly cared for. And, with 24-hour care support, we can make sure residents are secure and comfortable at any time of the day or night.”
Live Vibrantly! at Provident Village at Canton
At Provident Village at Canton, we believe vibrant days ensure bright tomorrows, so we’ve created a community where seniors, quite simply, Live Vibrantly! Whether it’s in our Assisted Living Community or Memory Care Neighborhood, each day we celebrate the individuality and strengths of each resident.
At Provident Village, to Live Vibrantly! means that days are filled with joy, vitality, growth and security. It means residents are socially active and personally empowered, with access to the personalized care and support they need to live fully. It means residing in a community where intellectual, social, emotional, spiritual and physical care are seamlessly integrated into everyday life.
Our compassionate Care Partners dedicate each day to enriching the lives of our residents. They customize the level of attention and activities to each resident’s specific needs and abilities. Our living environments are warm and inviting, with comfortable furnishings, beautiful fixtures and natural elements that bring the outdoors inside.