Managing sleeping issues for people with dementia

Fonthill House, St Albans, Hertfordshire

If you’re caring for someone who suffers from dementia, you may have noticed that they struggle to sleep at night or frequently get out of bed. However, this is a common occurrence as memory and behaviour begin to change, sleep patterns can alter along with it. There are ways you can support your loved one to help them sleep better if you follow our tips below.

How does dementia affect sleep?

Many people with dementia experience changes in their sleep patterns which are likely due to the impact on brain function which results in a disrupted circadian rhythm. Our body clock tells us when to sleep (at night) and when to wake up (in the morning). When this becomes damaged, patients with dementia may end up sleeping more during the day and less at night. Many scientists believe that cellular changes in the brain during dementia are what lead to the disruption of sleep patterns.

Why do dementia patients not sleep at night?

Getting enough sleep as a dementia patient can be a challenge, the ongoing changes to memory and the brain often result in sleepless nights. This could look like:

Difficulty getting to sleep
Waking up throughout the night
Light sleep that they are easily woken from
Less sleep overall

5 common sleep problems for people with dementia

Many people with dementia suffer from similar problems surrounding sleep. Here are some of the most common ones so that you can identify what someone may be struggling with:

1. Insomnia

The term insomnia encompasses several sleep problems including taking a long time to fall asleep, waking up frequently and having nightmares. Essentially, it results in not having a good night’s sleep on a regular basis. People with dementia often suffer from insomnia due to medication, behaviour and mood disturbances.

2. Sleep apnea

Sleep apnea refers to loud snoring, choking, and other respiratory symptoms that occur during sleep. It’s been found that around 50% of dementia patients suffer from sleep apnea at some point which can lead to a lack of sleep.

3. Restless legs syndrome (RLS)

RLS refers to an uncomfortable crawling or tingling sensation in your legs that’s only relieved by getting up and moving around. Often, symptoms worsen when resting, leading to disrupted and uncomfortable sleep.

4. Sundown syndrome

This refers to mood changes, anxiety, restlessness, anger and stubbornness that can often occur in dementia patients at night or in the early evening. Towards the end of the day, people with dementia are more fatigued or confused which can lead to sundown syndrome which disrupts sleep.

5. Rapid eye movement (REM) disorder

REM behaviour sleep disorder (RBD) causes someone to physically act out their dreams or sleep talk and shout. This can sometimes be dangerous if they are violent in their sleep or fall down. REM sleep disorder can be common in dementia patients.

How to help someone with dementia sleep

Sleep is so important as it gives our bodies time to recover and supports normal brain function. For someone with dementia to be losing sleep can only add further to their confusion, this is why it’s important to help improve their sleep in the following ways:

Treat underlying conditions — conditions such as sleep apnea and RLS can be treated which may be causing the sleep-related issues.

Establish a consistent routine — maintaining a regular schedule can help the body clock, so keeping the same times for eating, exercising and sleeping can be beneficial.

Daily exercise — regular exercise not only helps with sleep but is key to keeping healthy. Simply taking a walk at the same time every day will help the overall well-being of someone with dementia.

Exposure to daylight — natural light is what drives our circadian rhythm, so getting someone with dementia outside in the daylight once a day is important. If they’re unable to go outside, using a lightbox that replicates natural daylight and dims in the evening will have the same effect.

Avoid stimulants — alcohol, caffeine and nicotine all have a negative impact on sleep. Limiting the use of these, especially in the evening, can avoid sleep issues.

Avoid napping during the day — people with dementia often feel sleepy during the day but napping should be limited as much as possible. Sleeping during the day will only further disrupt the natural body clock.

Reduce screen time — blue light from TVs, smartphones, computers and tablets makes it harder to fall asleep and can be overstimulating. Try to limit the use of screens in the evening to help someone with dementia fall asleep easier.

Create a peaceful atmosphere — to help with sundown syndrome, cultivating a relaxing environment in the evening can help dementia patients feel at ease and sleepy. This could include dimming the lights, playing peaceful music or having a warm bath.

What is the best sleep aid for dementia patients?

There are certain medications and treatments available for dementia patients, however, these should only ever be administered by professional specialist carers. Examples of medications used to treat dementia sleep problems include:

Antidepressants
Sleeping pills
Benzodiazepines

Non-drug methods of improving sleep should always be attempted first as drug interventions can have side effects.

Suffering from sleep problems is always distressing, especially for those with dementia who are already struggling with memory changes. The above methods are a great way to help regulate sleep and maintain a healthy schedule.

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