Sleep and Dementia

Many people report a decrease in sleep quality and time as they age, and the effects of sleep disturbance can be significant. Too little sleep, or poor quality of sleep can lead to decreased functioning, mood changes, poor attention and concentration, problems with cognitive functioning, and depression. Overall, lack of sleep results in lower quality of life.

This can be especially true for caregivers, whose sleep is highly influenced by the sleep or restlessness of others.

Our bodies have an internal “clock” that helps tell us when to go to sleep and when to wake up. It is regulated by a hormone called melatonin. This hormone keeps our clock on time.

Many research studies suggest that as we age, we produce less melatonin, and therefore are less regulated in our sleep. In addition to this, we also have stress, diet, caregiving responsibilities, and the glow of the iPad to keep us awake. In patients with dementia, sleep disturbances are frequent, and often the result of deterioration of brain neurons and decreased hormones that we depend on to regulate sleep. This may lead to increased confusion, agitation, and wandering in the late hours of the afternoon as it begins getting dark, a phenomenon known as “Sundowning”. It can also lead to frequent daytime napping, which consequently interferes with night time sleep, or waking up and wandering during the night.

1. Get active.

It’s important to be active during the day. Being exposed to enough light, sunshine, and proper stimulation will keep melatonin production low and keep us active and alert. About 15 minutes of sunshine per day will also contribute to necessary Vitamin D production.

2. Wind down.

Exposure to bright lights at night may interfere with our melatonin production and slow down our natural processes that encourage sleep. This includes blue screens of televisions, iPads, and computers. Use these earlier in the day and wind down your evening with soft lights.

3. Practice good sleep hygiene.

Have a consistent routine of going to sleep and waking each day. Avoid major shifts in sleeping hours, and skip taking a nap if you have difficulty going to sleep at night. Avoid exercise, alcohol, caffeine, and nicotine before bed as these can be stimulating.

4. Caregivers need sleep.

If your loved one wakes during the night, stay calm. Gently guide them back to bed if they wander and remind them that it is bedtime. Keep them active and stimulated during the day and avoid daytime naps. If sleep disturbances are frequent and interfering with your ability to have regular, restful sleep, reach out to others for help and utilize respite services to allow you to rest. Sleep deprivation and exhaustion is not a sustainable plan, and increases the health risks for caregivers. Connect with your AFSC social worker and the Caregiver Resource Center for additional resources.

5. Talk to your doctor.

Talk with your doctor about any medications that might be interfering with sleep, or medications that may help your loved one sleep better. Remember to check with your doctor before getting a melatonin supplement. Even though melatonin can be purchased as an over the counter supplement, it may interact with other medications and may not be right for everyone.