Maria’s 78-year-old father had dementia. He slept most of the day and then called at night without waking. Maria thought his father’s daytime sleepiness and nighttime wakefulness were due to his medication. After a checkup with a psychiatrist, she learned that his sleep problems were due to dementia.
Maria’s story is not unique. Sleep problems are a common issue, affecting approximately 8 out of 10 people with dementia. These difficulties can make life difficult for both those with memory problems and their caregivers. Confused about why this happens? Let’s understand in this blog.
How does dementia affect sleep?
Research shows that people with sleep problems may be at higher risk for developing dementia later in life. The brain needs good sleep to eliminate toxins accumulated throughout the day. When sleep is insufficient, these factors can impair the brain over time.
Brain changes caused by dementia affect the sleep-wake cycle. As dementia progresses, the brain’s sleep-regulating problems worsen. This means that a person may be unable to sleep at night or to sleep deeply during the day. Their body loses its normal pattern of good nighttime sleep and daytime wakefulness.
The main causes of these problems are:
- Impaired brain’s internal clock system
- Changes in brain chemicals that control sleep
- Misperception of the time of day
- Fear or/and anxiety, especially at night
- Physical pain and/or restlessness
- Medication side effects
- Too much or too little exercise during the day
- Environmental factors in living conditions (e.g., noise issues)
How sleep problems look like in a dementia patient?
People with dementia experience sleep problems, but these vary from person to person. Some have difficulty falling asleep at a reasonable time, lie in bed for hours, and feel restless or anxious. On the other hand, those who finally fall asleep may wake up several times during the night.
Many people with dementia experience a condition called “sundowning.” In this condition, they become more restless and anxious as the evening and night progress. They often wander around the house, want to go out, or become very frightened. This makes it very difficult for them to sleep at night.
Many dementia sufferers may sleep a lot during the day and then stay up all night. They may think it’s morning when it’s actually midnight.
How does it affect families?
When a family member has dementia, poor sleep affects everyone. Caregivers may need to stay awake at night to ensure the patient’s safety, leading to inadequate sleep. When people sleep less, it impacts their mood and physical condition. Family members become anxious, sad, and sometimes even angry. Many families regret being tired or anxious, but this behavior is not wrong. Therefore, it is important for caregivers to seek help and get enough sleep to stay physically and mentally fit.
What helps dementia patients sleep?
Dementia-related sleep problems may seem overwhelming, but there are many ways help the person with dementia and their caregiver.
Helpful daily habits:
- Pick a specific time of day for bedtime and try to stick to it.
- Make a habit for a person with dementia to get natural light (e.g., taking a walk barefoot for at least 5 minutes in the morning)
- Nap for less than 30 minutes in daylight.
- The room should be well prepared (no lights, noises, or sounds) at night. The environment should be quiet at night.
- Following a healthy lifestyle, such as eating a balanced diet, staying active, and implementing stress management techniques.
- Practice relaxation methods, including soft music and scents, such as music therapy and aromatherapy
- Reducing hydration in the evening helps reduce nighttime urination. However, it’s important to ensure one drinks plenty of water.
As a caregiver, keep a record of the routines of the person with dementia, such as:
- What sleep schedule do they follow?
- How often do they wake up at night?
- What activities are they doing when they wake up?
- How long do they nap during the day?
- How high do they seem during the day?
This data helps doctors make a more accurate diagnosis.
When to seek professional help?
It is important to consult a mental health professional specialized in insomnia treatment, if a dementia patient is experiencing these problems, such as:
- Sleep issues persist for more than 2 weeks
- Loud snoring and intermittent breathing during sleep
- Physical pain
- Constantly fall asleep during the day
- Concerns such as dizziness and an increased risk of falls at night
- Impact on day-to-day activities
- Impact on the relationship
A mental health professional, such as board certified neuropsychiatrist, can understand the brain changes associated with dementia, as well as the sleep problems that come with it. They help with:
- Prescribing melatonin supplements to establish a proper sleep cycle
- Treating medical conditions that alter sleep
- Changes to medications currently being taken that interfere with sleep
- Sleep studies to diagnose sleep disorders like sleep apnea
Caregivers of Dementia Patients
When your loved one has sleep problems, you probably do too. This is very common and very difficult. Taking care of yourself is just as important as taking care of them.
- Seek professional help
- Ask family and friends for help during the day
- Consider hiring someone to help at night
- Join a caregiver support group
Protect your own sleep:
- Try to rest when your loved one is resting.
- Ask someone to take turns sleeping.
- Make the bedroom as comfortable as possible.
- Try to maintain at least some regularity in your sleep patterns.
Remember that:
- It’s okay to feel angry and tired.
- You can’t fix everything.
- Some days are more likely to be better than others.
- Seeking outside help doesn’t mean you’re failing.
- You’re not alone
Now you can meet with the psychiatrist of your choice online. At GABA Telepsychiatry, board-certified psychiatrists are dedicated to meeting people’s unique psychiatric needs and providing personalized care in secure and confidential online consultations.
However, remember that every person with dementia is different. What works for one person may not work for another. Be patient as people with dementia try different approaches. The most important thing is that you are trying to help your loved one feel safe, comfortable, and cared for.
