Sleep problems aren’t uncommon in the senior population, but for those living with Alzheimer’s and dementia sleep changes including insomnia or late-night restlessness are more common.
As Alzheimer’s progresses, it can cause the individual’s circadian rhythm to get off-kilter, reversing or rotating the body’s natural sleep/wake cycles. Then, there is the lack of physical exercise, or other health issues which can result in a body that can’t seem to ever get a good night’s sleep.
As a caregiver, coping with an Alzheimer’s sleep problems can be taxing. Nighttime is often a trigger for sundowning which can lead to agitated or even angry, resentful or disturbing behavior from a patient or loved one. Additionally, lack of sleep can exacerbate the side effects Alzheimer’s side effects, while a night of restful sleep can result in a person who is more calm, relaxed and peaceful the next day.
If Alzheimer’s sleep changes are an issue, these tips can help you establish healthier sleep habits.
Get Enough Exercise
If the individual is physically able, work within their ability and interests and aim for at least 30-minutes of physical activity every day. This may be as simple as a walk around the block, gardening, or attending a yoga class.
For those in a wheelchair or bed-bound, stationery exercises will get their muscles moving. Stationary exercises can be done in a chair or bed – using weights, stretching, manual motion and exercise bands. When done correctly, these exercises can maintain or even improve muscle tone, bone density and range of motion. We recommend reading, Chair Exercises and Limited Mobility Fitness to get started. You can also a doctor for a physical therapist who specializes in Alzheimer’s and/or senior care for a list of appropriate exercises and equipment.
If the person has been completely or mostly stationery up to this point, adding regular exercise can also lead to positive change in mood, digestion and even cognition as the result of increased circulation and engagement.
Limit Caffeine, Nicotine and Alcohol
Caffeine, nicotine and alcohol are all stimulants, known to interrupt sleep and relaxation patterns.
While limiting caffeine intake after lunchtime helps, remember caffeine may remain in the bloodstream for eight or more hours. Thus, cutting it out completely – replacing teas and coffees with decaf versions – is recommended. Keep in mind that even decaffeinated coffee or black tea contains small amounts of caffeine.
Natural Light Is Important
Human circadian rhythms evolved in the presence of sunlit days and dark nights. Evidence from multiple studies, shows artificial light can muck up this system. Even dim lights at night will interrupt the brain’s melatonin production, essential to experiencing healthy sleep cycles.
Getting your patient or loved one outside is optimal, but even spending a few hours each day next to a window – or using natural daylight as the predominant light source before sunset – can help to preserve the body’s natural rhythm. At The Memory Centers our Town Center is filled with natural light, one during nice weather we take advantage of our secure walking paths and courtyard.
Once the sun sets, find the balance between dim lighting that facilitates the brain’s natural sleep cycle and safety lighting. Or consider using red night-lights that are often less likely to disturb the body’s biochemical sleep processes.
Maintain Regular Schedules
Consistency is key in maintaining healthy sleep patterns. If a patient struggles to sleep soundly, make it a practice to wake them up, observe mealtimes and begin the bedtime routine at the same time each day. This helps to “train” the circadian rhythm. Read more tips on developing a schedule.
Limit Screen Time Before Bed
The blue light and images emanating from TV, tablet and smartphone screens can act as a stimulant and make it more difficult for the brain to wind down. Sleep experts recommend turning off all televisions and ceasing any other screen activity for at least 30-minutes before bedtime.
Make The Bed A Sleep-Only Zone
If eating, watching TV and staying in bed too much during the day the becomes the normal habitat, it can make bedtime a more restless experience.
If possible, make the bed a sleep-only zone, and have your loved one move to their chair or a couch if they’re awake or feeling restless. This promotes a healthy, sleep-oriented relationship with the bed.
Address Comfort Concerns
Any pain or discomfort can exacerbate insomnia. Test the patient’s bed – is it comfortable? Is the room too warm or too cold? Are they hungry or thirsty? Do they have the right amount of pillows? All of these factors can make it difficult to sleep. Also pay attention to movements or facial expressions to assess if pain might be an issue.
You Aren’t Alone
Caring for someone with Alzheimer’s or dementia is challenging – but it helps to know you aren’t alone. Talking to friends or family on a regular basis, taking breaks, or even participating in an online resource board such as ALZ Connected is recommended.