Dementia often changes sleep patterns. Families often complain that their loved ones with dementia are not sleeping well. Sleep-related symptoms may worsen as the disease progresses. But what causes these symptoms? Here, we discuss risk factors for sleep disorders and their associated effects.
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People with dementia often experience sleep disturbances that worsen as the disease progresses.
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Fragmented sleep at night and naps during the dayy is a common pattern.
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Talk to your nurse/care team about non-pharmacological measures to help improve sleep quality.
According to National Sleep Foundation guidelines, seniors should get seven hours of sleep each night. However, as we age, our sleep and wakefulness patterns change, affecting other bodily functions such as hunger. occurs. About 50% of people with dementia exhibit disturbed sleep patterns. Sleep-related symptoms usually worsen as the disease progresses. Research studies show that in long-term care facilities, up to 80% of people with dementia exhibit sleep-related symptoms.
Risk Factors for Sleep Disorders
Sleep cycles are controlled by the hypothalamus, a part of the human brain. It releases chemical signals (neurotransmitters) that help transition to sleep and wakefulness. Hypothalamic dysfunction alters sleep patterns when neural pathways in the brain are affected. To slow the decline of brain function, it is important to know the risk factors associated with sleep disorders.
- Obesity and sleep ApneaObese people may experience sleep apnea. In sleep apnea, breathing briefly stops and then resumes during sleep. Due to sleep apnea, dementia is exacerbated by not getting enough oxygen to the brain.
- Other chronic diseasesChronic conditions such as gastroesophageal reflux disease (GERD) can cause nighttime coughing and disturb sleep. Congestive heart disease can increase the frequency of nocturnal urination. Depression can cause excessive sleepiness.
- medicineMedications prescribed for other ailments can affect sleep patterns. For example, some drugs that lower elevated blood pressure, such as beta-blockers. It can cause insomnia, nightmares, and daytime fatigue. Decongestants given for cough/cold may delay falling asleep. Some steroids may increase nighttime wakefulness.
When a person with dementia (or a family member) reports sleep-related symptoms, a doctor may look into the chronic condition and adjust the dosage accordingly.
Sleep disturbance in dementia
People with dementia show altered sleep patterns and poor sleep quality. Some commonly observed symptoms are:
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nap
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insomnia
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it takes me a while to fall asleep
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wake up several times during the night
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get up early
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less sleep
In some people with dementia, the “sunset” begins in the late afternoon and lasts until midnight. They may become confused, anxious, and start ignoring instructions. Common symptoms of sunset include: Walks, yells, prowls, or follows family members wherever they go.
Restless legs syndrome (RLS), a movement disorder, is common in people with Lewy body dementia. After experiencing RLS, people with dementia have an uncontrollable urge to move their legs. Symptoms are relieved by movement, Your loved one may wake up and walk at nightPeriodic limb movement disorder (PLMD) is similar to RLS but involves movement of both legs and arms.
Rapid eye movement (REM) sleep is considered the fourth stage of sleep, and it is during this deep sleep stage that we dream. REM sleep behavior disorder is characterized by dream behavior, such as hitting or kicking someone. In such situations, the patient could potentially injure themselves through injury or falls.
The relationship between sleep and dementia can best be described as bidirectional. Sleep disturbances increase the risk of dementia and vice versaSleep apnea and insomnia are common sleep disorders that increase the risk of dementia.
Measures against sleep disorders
There are several ways to help a loved one with dementia cope with sleep problems.
- sleep diary. A sleep diary is a simple but effective tool for understanding your loved one’s sleep patterns. A sleep diary usually records the time you went to bed, the time you woke up, the number of times you woke up during the night, and other relevant symptoms such as talking in your sleep.
- safe environment. Make sure your loved ones are safe when they wake up at night (such as bed railings).
- healthy lifestyle. These symptoms can be distressing for people with dementia and their families, but some simple lifestyle changes may prove beneficial. Sun exposure reduces daytime sleepiness and increases nighttime sleep. Maintaining sleep hygiene by maintaining a regular schedule and limiting caffeine can be very helpful.
- exercise. Physical activity can also improve sleep quality in people with dementia. Light exercise such as walking, jogging, or dancing is effective, depending on your physical ability. As the disease progresses, doing household chores such as gardening and washing can provide needed physical activity.
- alternative medicine. Some people like to try alternative medicine such as massage therapy and aromatherapy. Aromatherapy uses a variety of essential oils to be applied to, bathed in, or massaged into the skin. These oils are diluted with another carrier oil such as jojoba oil or coconut oil. Research studies have shown that lemon balm and lavender oil have beneficial effects in people with dementia. There is limited scientific evidence for other alternative therapies.
Before using any alternative therapy, gather information on its safety and effectiveness. Also, discuss with your care team which options will work for you. Your doctor may prescribe medication to your loved one if non-pharmacological approaches do not prove effective. Please discuss about