Alzheimer’s disease: managing sleep disorders
If you are caring for a loved one who has Alzheimer’s disease, sleep disorders can hurt both of you. Here it helps to promote a good night’s sleep.
Sleep disorders and Alzheimer’s disease are often closely linked. Understand what causes sleep disorders in people with Alzheimer’s disease and other dementias, and what you can do to help.
General sleep problems associated with dementia
Many older people have sleep problems, but people with dementia often have even more difficult times. Sleep disorders can affect up to 25%. Percentage of people with mild to moderate dementia of 50% or more Sleep disorders tend to worsen as the severity of dementia increases in people with severe dementia.
Possible sleep problems include excessive daytime sleepiness and insomnia, which makes it difficult to fall asleep or stay asleep. Frequent night awakenings and early morning awakenings are also common.
People with dementia may also experience a phenomenon called sunset in the evenings and at night. They may feel confused, upset, anxious, and aggressive. Night wanderings in this state of mind may not be safe.
Obstructive sleep apnea is also common in people with Alzheimer’s disease. This potentially serious sleep disorder causes repeated arrests and initiations of breathing during sleep.
The factors that can contribute to sleep disorders and sunset are:
- Mental and physical fatigue at the end of the day
- Changes in the body clock
- The need for sleep deprivation, which is common in the elderly
- Decreased lighting and increased shadows that can cause people with dementia to be confused and afraid
Support for a good night’s sleep
Sleep disorders can hurt both you and people with dementia. To promote better sleep:
- It deals with the underlying condition. Symptoms such as depression, sleep apnea, and restless legs syndrome can cause sleep disorders.
- Establish a routine. Regularly maintain meals, awakenings, and bedtime.
- Avoid stimulants. Alcohol, caffeine and nicotine can interfere with sleep. Limit the use of these substances, especially at night. Also, avoid TV when you are awake at night.
- Encourage physical activity. Walks and other physical activities can help promote a better night’s sleep.
- Limit sleep during the day. Stop taking an afternoon nap.
- Feel calm in the evening. Read loudly and play soothing music to help people relax. Comfortable bedroom temperature helps people with dementia sleep well.
- Manage your medicine. Some antidepressants, such as bupropion and venlafaxine, can cause insomnia. Cholinesterase inhibitors, such as donepezil, can improve cognitive and behavioral symptoms in people with Alzheimer’s disease, but they can also cause insomnia. Talk to your doctor if people with dementia are taking these types of medications. In many cases, it is effective to administer the drug by dinner.
- Consider melatonin. Melatonin may help improve sleep in people with dementia and reduce sunsets.
- Provides proper light. Bright evening phototherapy can reduce sleep and wake cycle disorders in people with dementia. Proper lighting at night can also reduce the agitation that can occur when the surroundings are dark. Regular exposure to sunlight may address the problem of day-night reversal.
When a loved one wakes up in the middle of the night
If a person with dementia wakes up in the middle of the night, calm down even if they are exhausted. Please do not insist. Instead, ask what the person needs. Nighttime agitation can be caused by discomfort or pain. See if you can identify the cause of the problem, such as constipation, a full bladder, or the room being too hot or too cold.
Gently remind him or her that it is a night and time for sleep. If a person needs to keep pace, do not restrain him or her. Instead, allow it under your supervision.
Use of sleeping pills
If the non-drug approach does not work, doctors may recommend drugs that induce sleep.
However, sleep-inducing drugs increase the risk of falls and confusion in older people with cognitive impairment. As a result, sedative hypnotics are generally not recommended for this group.
If these medications are prescribed, your doctor may recommend that you try to discontinue use once your normal sleep pattern is established.
Remember that you also need sleep
If you don’t get enough sleep, you may not have the patience and energy needed to care for someone with dementia. The person may feel your stress and get excited.
If possible, have your family and friends take turns spending the night. Or talk to your doctor, social worker, or representative of your local Alzheimer’s Association to find out what kind of assistance you can get in your area.
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- Insomnia and sunset. Alzheimer’s Association. https://www.alz.org/care/alzheimers-dementia-sleep-issues-sundowning.asp. Accessed on December 2, 2019.
- Treatment for changes in sleep. Alzheimer’s Association. https://www.alz.org/alzheimers-dementia/treatments/for-sleep-changes. Accessed on December 2, 2019.
- 6 Tips for Managing Sleep Disorders. National Institute on Aging. https://www.nia.nih.gov/health/6-tips-managing-sleep-problems-alzheimers. Accessed on December 2, 2019.
- Kryger MH, et al. , Eds. Alzheimer’s disease and other dementia. In: Principles and practices of sleep medicine. 6th Edition Elsevier Saunders; 2017. https: //www.clinicalkey.com. Accessed on December 2, 2019.