According to the Alzheimer’s Association, people with Alzheimer’s or dementia often have problems with sleeping or may experience changes in their sleep schedule.
To create an inviting sleeping environment and promote rest for a person with Alzheimer’s the following are recommended:
- Maintain regular times for meals and for going to bed and getting up.
- Seek morning sunlight exposure.Encourage regular daily exercise, but no later than four hours before bedtime.
- Avoid alcohol, caffeine and nicotine.
- Treat any pain.
- If the person is taking a cholinesterase inhibitor avoid giving the medicine before bed.
- Make sure the bedroom temperature is comfortable.
- Provide night lights and security objects.
If the person awakens, discourage staying in bed while awake: use the bed only for sleep.
Scientists do not 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.
Many people with dementia wake up more often and stay awake longer during the night. Brainwave studies show decreases in both dreaming and non-dreaming sleep stages. Those who cannot sleep may wander, be unable to lie still, or yell or call out, disrupting the sleep of their caregivers.
Individuals may feel drowsy during the day and then be unable to sleep at night. Some may become restless or agitated in the late afternoon or early evening, and experience “sun downing”. Experts estimate that in late stages of Alzheimer’s individuals spend about 40 percent of their time in bed at night awake and significant part of their daytime sleeping.
Conditions that can make sleep problems worse include:
- Restless leg syndrome: a disorder in which unpleasant “crawling” or “tingling” sensations in the legs cause an overwhelming urge to move them.
- Sleep apnea: an abnormal breathing pattern in which people briefly stop breathing repeatedly during their sleep.
A thorough medical exam is recommended to identify any treatable illness that may be contributing to the problem.
For sleep changes due primarily to Alzheimer’s disease, there are non-drug and drug approaches to treatment. Most experts and the National Institutes of Health strongly encourage use of non-drug measures rather than medication.