Sleeping

Sleeping can become a problem for many people with dementia, and sometimes it’s the most difficult problem they face.


They might sleep during the day and be restless at night, they might get confused between night and day, and they might not need as much sleep as before because they’re not as active.

Problems with sleeping or late evening restlessness are often a stage in dementia that eventually passes, and many people with dementia sleep more as their condition gets worse.

Causes of sleeping problems

Think about what could be causing the problem – is it their environment, or maybe the medications they’re taking? Keeping a sleeping log might help you find a pattern that points to a problem, and then you can find a way to fix it.

Causes

Solutions

Effects of medication – such as for heart conditions, diabetes, ulcers, urinary tract infections, sleep apnoea, restless legs, depression.

See the doctor for a check up to treat physical symptoms and/or to discuss changing or stopping medication if appropriate.

Pain caused by conditions, such as arthritis.

 

Ask the doctor about pain relief, especially for bedtime.

Depression – can cause early wakening without being able to go back to sleep.

Have them assessed for depression, and started on any appropriate medication.

Environmental causes – any changes in their sleeping environment, too hot/cold, can’t find the light, can’t find the bathroom.

  • Keep their sleeping environment as consistent as possible.
  • Check whether they are too hot or too cold when they wake up.
  • Make sure there’s adequate lighting – install night lights.
  • Use a commode – or mobile toilet – in their bedroom during the night to minimise disruption when needing to go to the toilet.
  • Make sure their bed and bedroom are comfortable.
  • Put away their daytime clothes so they don’t see them and think it’s time to get up.
  • Exercise can help people sleep, so make sure they get some walking in each day..

Other causes may include:

  • Too much caffeine or alcohol
  • Going to bed too early
  • Sleeping too much during the day
  • Over-tiredness making them tense and unable to relax into sleep
  • Not enough exercise so they don’t feel tired
  • Feeling hungry
  • Wound up after an upsetting incident
  • Bad dreams.

 

Other tips to manage these include:

  • Cut down on caffeine during the day and stop altogether after 5pm.
  • Cut down on alcohol and talk to the doctor about whether that might be reacting with the person’s medication.
  • Doing an activity after dinner to keep them up a little later.
  • If you think they might be hungry at night, give them something to eat just before bed, or when they first wake up in the hope they will go back to sleep.
  • Herbal teas and warm milk may be helpful to relax them.
  • Try not to do any tasks that may be upsetting in the late afternoon, such as bathing.
  • If they refuse to go to bed offer alternatives, such as sleeping on the couch.
  • Try a back rub before bed or if they wake up.
  • Try playing soft music by their bed
  • Gently remind them that it’s night time and time to sleep.
  • Sometimes sleeping pills might be needed, so talk to their doctor about whether that might be appropriate.

 

There is help available for you as you care for someone with dementia, contact your local Alzheimers organisation for more information.