Dementia care: Coping with disturbed sleep patterns

Submitted by AgedCarer on Fri, 19/09/2008 - 8:56pm

For caregivers being awakened repeatedly at night and missing out on essential sleep can be one of the most disturbing and stressful aspects of being a carer.

Dementia and sleep disturbance

If you are caring for someone with dementia who is restless or has problems sleeping at night, seek help early on. People with dementia commonly have disturbed sleep patterns. They may wake up persistently through the night or have problems falling to sleep. Some people with dementia tend to wander at night or be more agitated and restless.

There are many reasons why someone with dementia can have problems sleeping including:

Exhaustion
An inability to recognise night and day
Reduced need for sleep as seen in elderly people
Increased disorientation
Unable to distinguish dreams from reality when sleeping
Over doing day time napping
Other existing medical problems

Sleeping for long periods and preferring to remain in bed all day can be signs of depression. Certain medications can also make people drowsy and increase daytime napping.

If you are worried about a loved one's sleep patterns or you are not getting enough sleep yourself, see your doctor. Sleep disturbance usually occurs in the middle stages of dementia and eventually passes.

Pay attention to the environment

If a person with dementia wanders at night, try and make the environment as safe as you can. Close doors to the kitchen for instance, allow the person with dementia a safe place to wander by leaving on night-lights. Installing motion and door sensor alarms can relieve constant worry that a loved one may wander out at night.

A person with dementia may not recognise the temperature and use bedding or wear clothes that are inappropriate to the season. Are they too hot or feeling the cold?
Is the room familiar? Does the person have a comforting item they can take to bed such as a comfort rug or night torch?
Ensure the person is comfortable by pulling curtains and reducing bright light, use bed lamps to avoid disorientation and fear
Night-lights can be beneficial for highlighting the way to the toilet
A commode by the bed can be useful for night time toileting
Do not leave out daytime clothes, as may be a cue to get up
Reduce excessive noise from a TV or stereo (some people find a familiar tune comforting at night)

Tips for coping with disturbed sleep patterns

Avoid long naps during the day but make sure the person gets adequate rest, as fatigue can increase restlessness
Encourage exercise during the day
Consider whether a person is hungry, thirsty or in pain
Encourage exposure to light in the afternoon
Give warm milk, play calming music and encourage quiet activities in the evening
Establish a set routine for sleep and wake times, keep a diary to establish what times work best
Avoid caffeine, smoking and alcohol
Toilet the person as late as possible before bed
Consider the use of incontinence pads or scheduled toileting at night if waking because of incontinence
Burn essential oils to promote sleep or spray around room and or on a pillow
Ask your doctor to review medications
Avoid routine use of sedatives (sleep tablets)
Some people sleep better in a comfortable favourite chair or couch

Helpful resources

Ring the National Dementia Helpline on 1800 100 500 to talk to a counsellor at Alzheimer's Australia.
Contact The National Dementia Behaviour Advisory Service (NDBAS) on 1300 366 448. A national telephone line for carers or family concerned about the behaviour of people with dementia.