It is common for people with Alzheimer’s to experience changes in their sleep cycles. The association between sleeping problems and Alzheimer’s has been noted but scientists do not yet completely understand why these sleep disturbances occur. As with changes in memory and behavior, sleep changes somehow result from the impact of Alzheimer’s on the brain.
Sleep changes in Alzheimer’s may include:
Insomnia. Many people with Alzheimer’s suffer from the inability to stay asleep. They may wake up more often and stay awake longer during the night. Those who cannot sleep may wander, be unable to lie still, yell, or call out to a caregiver.
Daytime napping and other shifts in the sleep-wake cycle. It is also common for individuals with Alzheimer’s to feel drowsy during the day and then be unable to sleep at night. Daytime naps are common and they may become restless or agitated in the late afternoon or early evening. In extreme cases, people may have a complete reversal of the usual daytime wakefulness-nighttime sleep pattern.
For sleep changes due primarily to Alzheimer’s disease, there are non-drug and drug approaches to treatment. However, most experts and the National Institutes of Health (NIH) strongly encourage the use of non-drug measures rather than medication. The use of sleep medications in patients with dementia is associated with a greater chance of falls and other health risks that likely outweigh their benefits.
Non-drug treatments for sleep changes:
Non-drug treatments aim to improve sleep routine and the sleeping environment in a way that is natural and safe. It is all about managing daytime energy levels and creating a comfortable environment for sleep optimization during the night. Non-drug coping strategies should always be tried before medications since some sleep medications are known to have serious side effects. Here are some tips for repairing the sleep cycle of a loved one with Alzheimer’s:
Maintain regular times for waking up and going to sleep. It is recommended that adults over 50 get at least 6 hours of sleep during the night. In addition to scheduling a time for waking and going to sleep, meal times should also be loosely coordinated. What we eat and when we eat it contributes greatly to our levels of energy throughout the day. For peak energy during the day breakfast should be of a substantial size and never skipped. The last meal of the day should be consumed no later than an hour before bed. This gives the body time to digest before it falls asleep, allowing for a more dormant and deeper sleep during the night.
Seek morning sunlight exposure
Our circadian rhythm is intrinsically linked to the day/night cycle of the sun and moon. Getting outside in the morning and exposing the skin to sunlight is extremely effective for boosting energy levels and improving our overall moods. Try taking your loved one outside for at least 10 minutes every morning and getting some sunlight. The more sun – skin contact that is possible, the better. Practicing this daily, you are sure to see the benefits not only for your loved one, but for yourself as well.
Encourage regular daily exercise, but no later than four hours before bedtime
It may sound counterintuitive, but exercise is a great way for boosting energy levels during the day. If one is laying around on the couch watching TV all day, it is unsurprising that they may feel tired or sluggish (think Newton’s first law of inertia!). Combine your outside sunlight time with a walk around the neighborhood if possible. If it is not, try alternatives like chair yoga. Exercise and movement are vital for regulating our levels of mindfulness, energy, and sleep.
Avoid alcohol, caffeine and nicotine
Stimulants that alter our mindstate have been found to also affect our levels of sleep. If your loved one is experiencing trouble sleeping and is also consuming these common stimulants regularly, try cutting them out and see if an improvement in sleep follows.
Sometimes physical pain from other medical conditions (joint pain, lower back pain, stomach pain, etc.) can prevent someone from falling asleep properly. If this is the case for your loved one, seek ways to reduce their pain so that they may be more comfortable when they lay down to sleep.
Make sure the bedroom temperature is comfortable
Your bedroom should be quiet, cool, and dark for the best chance at getting good quality rest. When providing a room for someone with Alzhiemer’s to sleep in, make sure it is dark and a bit on the cooler side to optimize their sleep. You can provide them an extra blanket or two on the bedside in case they get too cold, but it should never be too hot that they feel uncomfortable or start sweating. Starting at a baseline that is cool, you can then allow them to adjust their temperature with the use of blankets until they are comfortable.
Medications for sleep changes:
In some cases, sleep disturbances may be so severe that non-drug approaches fail to work. For those individuals who do require medication, it is very important to seek the advice of a medical professional first. The risks of sleep-inducing medications for older people with dementia are considerable. They include increased risk for falls and fractures, confusion and a decline in the ability to care for oneself. The decision to use an antipsychotic drug should be considered with extreme caution. These drugs are associated with an increased risk of stroke and death in older adults with dementia. The FDA has ordered manufacturers to label such drugs with a “black box” warning about their risks and a reminder that they are not approved to treat dementia symptoms.
Treatment goals are likely to change during your journey with Alzheimer’s disease. Make sure you understand all the available options and the benefits and risks of each choice as your treatment plan evolves. At Nursepartners we service our clients with highly trained and professional nurses who are trained in implementing a wide array of different care strategies. To learn more about the services we provide call us today at 610-323-9800.
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