Often, people who live with dementia experience poor sleep. At the same time, sleep disorders including insomnia and sleep apnea can be indicators that a person is at risk of developing dementia symptoms. Unfortunately, sleep often gets worse over time for Alzheimer's and dementia patients as the condition progresses. However, with improved sleep hygiene and the support of a Qualicare Care Coordinator and their Care Team, there are steps you can take to help your loved ones sleep better.
Why Alzheimer's and Dementia Patients Are at Risk for Poor Sleep
Brain changes that occur due to dementia and Alzheimer's can contribute to poor sleep. Patients experience an overall reduction of the REM phase of sleep, which results in higher REM latency. Alzheimer's patients experience neuronal degeneration, which damages the basal forebrain and reticular formation of the brain stem. These two regions help regulate sleep patterns, and damage can lead to sleep pattern changes in Alzheimer's patients.
Insomnia is often a warning sign of dementia, as there may be a link between sleep deprivation and an increased risk of Alzheimer's. Often, Alzheimer's patients see sleep pattern changes as one of the first symptoms. During waking periods, levels of amyloid-beta protein rise in the bloodstream, and they decline during sleep. This protein is part of the brain plaques found in Alzheimer's patients. Elderly people who complain of daytime sleepiness, restless nights, and increased use of sleep aid medications are more likely to develop Alzheimer's symptoms within two years.
Common Sleep Disorders for Alzheimer's and Dementia Patients
People with dementia and Alzheimer's typically experience sleep disorders at a higher rate than others. Sleep difficulties that are common with dementia and Alzheimer's include:
REM sleep behavior disorder
Restless legs syndrome
Periodic limb movement
Sleep-disordered breathing, including sleep apnea
Longer sleep latency, increased sleep fragmentation, and a decrease in sleep efficiency and sleep time are common among dementia patients. Patients with sleep struggles often experience daytime sleepiness, nighttime wandering, confusion, and agitation.
Unfortunately, sleep struggles tend to get worse as patients with dementia and Alzheimer's age. Patients experience progressively less REM sleep at night and an increase in nighttime wakings. If this is something you suspect is causing trouble for your loved one, speak with your local Qualicare Care Coordinator to determine how to proceed in getting him or her back on track.
How to Improve Sleep for Patients with Dementia and Alzheimer's
Addressing the symptoms of Alzheimer's and dementia can be helpful in improving sleep. Additionally, some doctors may recommend sleep therapy or medications. Some institutionalized care facilities administer sedatives for nighttime sleep. There are other steps you can take to support healthy sleep in patients with dementia and Alzheimer's. By discussing options with your loved one’s Qualicare Care Coordinator, you can find the best solutions for him or her.
Take safety precautions. Reduce the risk of injury during sleep. Remove dangerous objects from the bedroom. Lock doors and windows, especially if the patient is prone to nighttime wandering.
Maintain a consistent sleep schedule. A regular sleep schedule supports maintaining circadian patterns. Help patients fall asleep and wake up at the same time each day.
Use light exposure. Encourage patients to spend time outside during the day to realign their circadian rhythm. Exposure to natural sunlight can help to reduce the effects of sleep disorders including insomnia. Patients who can't go outside may benefit from using bright lamps designed for light therapy.
Consider diet and exercise. Dairy and grains can help induce sleepiness, while alcohol, tobacco, and caffeine can make it difficult to fall asleep. Light physical activity can help lead to higher levels of sleep. Walks and nighttime stretching can be helpful.
Create a healthy sleep environment. A patient's sleeping environment should be quiet, dark, cool, and comfortable. The mattress should meet their needs and reduce discomfort. Ideally, beds should be used only for sleep and sex, not eating or watching television. Moving patients to a chair during the daytime can make it easier to sleep in the bed at night.
Written by: Sara Westgreen, a researcher for the sleep science hub Tuck. She sleeps on a king size bed in Texas, where she defends her territory against cats all night. A mother of three, she enjoys beer, board games, and getting as much sleep as she can get her hands on.