Disrupted sleeping regularly affects people living with dementia, impacting their restfulness, health and wellbeing, which can impact the rest and quality of life for their families and loved ones.
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Understanding the challenges of sleeping with dementia means you can find practical solutions that work for your loved one and help them get a better night’s sleep.
How dementia impacts sleep
As a neurodegenerative disorder, the brain changes that occur with dementia directly affect the body’s internal clock. The disorder damages the part of the brain that regulates our sleep-wake cycle, (the suprachiasmatic nucleus), meaning people with dementia often lose their natural circadian rhythm, which impacts every aspect of the rest of your loved one’s life.
This is why a person living with dementia may be wide awake at 2 AM or exhausted just after lunch. Also known as sundowning, this is a common side effect of dementia. Many people experience increased confusion, agitation, and restlessness into the afternoon or as evening approaches. Fading light, such as at sunset, can trigger anxiety and disorientation and caregivers may notice their loved ones often become more challenging or upset during these hours, making bedtime routines increasingly stressful.
Physical discomfort can also inhibit good sleep. Arthritic pain, the need to use the bathroom frequently, or uncomfortable room temperatures may wake someone repeatedly throughout the night, especially if they were a light sleeper before their dementia diagnosis. People who experience sleeping with dementia will naturally struggle to identify or communicate these problems to you and might simply feel distressed without understanding why.
Helping to create a good sleep environment
The bedroom should become a sanctuary for your loved one to rest. Keep the room cool, quiet, and dark during nighttime hours. Many families find success with nightlights that provide just enough illumination to prevent falls, without being stimulating and keeping your loved one awake. Blackout curtains can help, especially during New Zealand’s long summer evenings, where it stays hot long into the night.
A small snack before bed can help to prevent hunger from causing nighttime waking. Warm milk or chamomile tea can promote relaxation, though be mindful of how liquids may increase the incidence of more bathroom visits.
Consider whether any active medications your loved one is taking may be affecting their rest. Some dementia medications, as well as treatments for other conditions, may heighten insomnia or excessive daytime sleepiness. Discuss timing and dosages with your GP or specialist to see if they have recommendations for the timing of certain medications to improve sleeping with dementia, such as earlier in the day.
Learning how to get someone with dementia to sleep at night
Implementing a consistent daily routine forms a foundation for better sleep. The body responds well to predictable patterns, even where dementia has impacted the brain’s internal clock.
We recommend caregivers try to wake the person living with dementia at the same time each morning, serving meals at regular intervals, and beginning the bedtime routine at the same hour every evening. A daily structure like this can gradually retrain disrupted sleep patterns and ease the challenge of sleeping with dementia.
Being exposed to natural light during daytime hours can make a big difference. Take your loved one outside in the morning or open the curtains and window to let sunshine stream in. Bright light tells the brain it’s time to be alert and active. Research shows that exposure to bright ambient light in the morning can significantly improve sleep efficiency and sleep time in older adults with dementia.
Physical activity helps tire the body out. Encourage gentle exercise like walking, gardening, or dancing to familiar music during the day. Avoid vigorous activity after 6pm, as this can have the opposite effect by energising them too close to bedtime. Even simple household tasks like folding laundry or setting the table can provide beneficial movement.
Care and compassion go a long way
Your patience and care will go a long way towards helping your loved one sleep well and communication will go a long way in soothing stress. It’s very natural for fear, apprehension or disorientation to accompany poor sleep. Many people feel frightened or confused when darkness falls, so providing a familiar object like a favourite blanket, a photo of loved ones on the bedside table, or soft background music can provide comfort at these times. This is a form of reminiscence therapy (RT) which has been noted to be effective with some sleeping with dementia patients.
When professional support helps
If sleep problems persist and your loved one isn’t getting regular quality sleep, specialised dementia care facilities can provide relief. Professionals understand how to help people to help those sleeping with dementia get to sleep at night using evidence-based approaches. They maintain structured routines, provide appropriate daytime stimulation, and monitor for underlying health issues that might disrupt sleep.
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