Dementia and Sleep: How Can You Help Your Loved One Rest Better?

Learn more about the connection between dementia and sleep issues, including practical tips to improve sleep and how in-home dementia care can help.

Elderly man with dementia struggling to fall asleep.

Dementia changes everything, including sleep. As we age, we all experience changes in how well and when we sleep. However, these changes are often more pronounced for someone living with dementia. Sleep disturbances vary greatly depending on the type and stage of dementia, but their effects are universally challenging. Disrupted sleep can exacerbate dementia symptoms such as memory loss, confusion, and anxiety.

None of us are at our best without a good night’s rest, so high quality and adequate sleep are crucial for someone coping with cognitive changes In addition, poor sleep for the person living with dementia also means poor sleep for those who live with and care for them. Addressing these sleep issues is critical, yet it can feel like just one more daunting task for family caregivers who are already strained. Thankfully, there are simple things we can do to improve sleep hygiene and environment. In-home dementia care can be a vital part of the good sleep puzzle.

Common Sleep Challenges in Older Adults

As we age, our sleep patterns can change. Often, these changes are not due to aging itself but are related to other health conditions common in older adults. Adjusting our sleep habits can help ensure we still get the rest we need. Dementia can introduce additional sleep challenges.

Expected changes in sleep as we age:

Sleep fragmentation: sleep happens in disrupted segments throughout the night rather than one long stretch.

Decreased sleep efficiency: more time awake in bed, leading to grogginess and low energy during the day.

Phase advance: tendency to go to bed and wake up earlier.

Sleep challenges exacerbated by dementia:

Insomnia: Difficulty falling or staying asleep.

Hypersomnia: Excessive daytime sleepiness.

Sleep Apnea: Interruptions in breathing during sleep.

REM Sleep Behaviour Disorder: Acting out dreams, often seen in Lewy body dementia.

Circadian rhythm disruptions: Sleep does not follow standard day/night patterns

Insomnia and Dementia

Insomnia is a frequent complaint among people with dementia. Factors such as anxiety, depression, and the side effects of medications can all contribute to insomnia. Hospitalization often exacerbates insomnia due to the poor sleep environment. Insomnia and circadian rhythm disruptions can be very challenging without 24-hour care support, especially since confusion tends to increase overnight. Sleep hygiene practices and behavioural interventions can help manage insomnia and promote better sleep patterns.

Sleep Apnea and Dementia

Sleep apnea, where breathing repeatedly stops and starts during sleep, is another common issue. This can lead to fragmented sleep and reduced oxygen levels, further impacting cognitive functions. Addressing sleep apnea through medical interventions such as CPAP therapy can significantly improve sleep quality and overall health in people living with dementia.

Do People with Dementia Sleep a Lot?

Contrary to insomnia, some people with dementia sleep excessively, a condition known as hypersomnia. This can be due to changes in the brain caused by dementia or the side effects of medications. Understanding and managing hypersomnia involves balancing sleep patterns and encouraging more daytime activities.

It’s important to listen to the needs of the person with dementia. Once conditions are set to promote good sleep and you are sure there are attractive daytime engagement options, follow your loved one’s cue for how much sleep they need. Frequently, near the end of someone’s journey with dementia, more and more time is spent sleeping. If this does not cause distress, you do not need to force the person to stay awake.

How can Seniors Improve their Sleep?

With or without dementia, there are many things seniors can do to improve their sleep hygiene. Sleep hygiene refers to all the things we do to promote good sleep in the same way that personal hygiene encourages and supports our physical health. Here are a few tips to get you started.

4 General Senior Sleep Tips:

  1. Avoid all screens before bedtime. Blue light emitted from screens can keep you up if you use them before bed and during overnight wake-ups. A red book light can be very helpful if you like to read.
  2. Maintain a regular sleep schedule. Going to bed and waking up at the same time every day helps regulate the body’s internal clock.
  3. Create and adhere to a bedtime routine. Calming activities such as reading or listening to soothing music can signal to the brain that it’s time to wind down. A warm shower or bath before bed is a great way to cue the body’s natural sleep processes.
  4. Keep track of your sleep. Our memory can be biased. A few bad nights’ sleep might feel like a pattern going on forever, or we can dismiss months of lousy sleep as ‘just one night.’ Using a sleep tracker can help you objectively know what is going on so you can get the support you need.

Of course, some modifications are needed to account for cognitive and behavioural changes in seniors with dementia. Understanding your loved one’s specific symptoms and how to manage them can make it easier to improve their sleep hygiene.

3 Dementia-Specific Sleep Tips:

  1. Clearly communicate sleeping and waking times. In addition to telling your loved one when it’s time to wake up and go to sleep, you can use visual and audible cues to better establish a routine. There are lights built with timers that change color when it is time to rise and sleep. Many also include sound machines, which support a good sleep environment. You can also use a 24-hour analog clock and color the face of it for sleep and wake times.
  2. Maintain the pre-diagnosis bedtime routine. This will increase comfort and aid sleep. Work more efficiently with your loved one’s dementia by being attuned to where in history they are presently residing. Are they in their childhood? If so, a routine that mimics theirs from that time will be more soothing and supportive.
  3. Provide comfort and security. Confusion can increase at night, so it is best to provide lots of cues in their room that they are safe and where they are supposed to be. Photos of loved ones, cherished objects, a note to read, or a favorite book can all be helpful.

Creating a Supportive Sleep Environment

Where we sleep is a crucial part of the quality of our sleep. Creating the right sleep environment can improve comfort and help with falling asleep and staying asleep. Consider making the following adjustments to your loved one’s sleep environment:

Help them get comfortable. Many people don’t realise this, but sleeping in a bed can become less comfortable for older adults. An adjustable bed or lift chair often becomes the preferred sleep spot. If this is the case, move the chair into the bedroom.

Use the bed only for sleep. Although many people are in the habit of reading, scrolling on their phones, or taking calls in bed, this can confuse the body. Avoiding other activities in bed helps signal to the body that it is time for a long sleep. If possible, have your loved one nap in a different room on a chair or couch.

Get the temperature right. It is easier to sleep when we are cool. Have the room cool with cozy blankets. If your loved one has trouble falling back asleep, having them spend time out of bed and cooling their body off can be a good reset.

Sound and scent. A sound machine can help avoid being awoken in noisy environments. Aroma therapies such as lavender, vanilla, and ylang-ylang support sleep in a diffuser or room spray.

Use light to help the body know when to sleep. Make sure your loved one gets into sunlight during the day and ensure there is as little light pollution as possible when sleeping. Keep in mind that your loved one may need a night light, however, if they wake during the night and get out of bed.

Use of Sleep Medications

Use sleep medications with caution due to potential side effects, especially for people with dementia, and the risk of dependency. Many sleep medications do not induce the same restorative stages of deep sleep needed for optimal brain function and can exacerbate cognitive difficulties. Non-pharmacological treatments are often preferred to avoid these risks.

The Role of In-Home Dementia Care

In-home dementia care can be a game-changer for managing sleep issues. Professional caregivers are trained to:

● Keep patients active and engaged during the day to reduce daytime sleepiness and limit naps.
● Implement sleep hygiene practices.
● Monitor and manage sleep patterns.
● Provide overnight care to ensure safety and comfort.

In-home care provides not only skilled dementia care but also much-needed respite for family caregivers. It ensures that your loved one receives consistent care and supervision, reducing the stress on family members. No one can provide 24/7 care themselves, therefore it’s important to take breaks when caring for our loved ones.

By following these guidelines and utilizing available resources, families can better manage the sleep challenges associated with dementia, ensuring a better quality of life for their loved ones and themselves. In-home dementia care offers a valuable resource, providing professional support and relief for families navigating these challenges.

For more information on managing sleep in dementia patients and the benefits of in-home care, contact TheKey today.