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Sleep and Dementia: Unveiling the Challenges

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Southern Cross Care

Sleep and Dementia - Unveiling the Challenges

Sleep disturbances are common among individuals living with dementia. In fact, up to half may experience abnormal sleep patterns.

 

How is sleep different for people with dementia?

People with dementia are often sleepy during the day and have difficulty with sleeping for long periods at night. It is also common to have a lighter sleep. This may be due to dementia directly or can be a result of changes in how they perceive the world. Some forms of dementia can also disrupt the ‘body clock’, where the hormones that help us sleep are released earlier in the day instead of during the typical bedtime.
 

What are the causes of these changes in sleep?

Many factors can contribute to these sleep changes. How the brain controls sleep may have changed. Or, people with dementia may have an underlying issue such as pain that needs to be addressed. They may be less active during the day so they have more energy at night. Their sleeping environment may not be conducive to sleep or they may have experienced issues with sleeping in the past, have an underlying sleep disorder such as periodic limb movement disorder, obstructive sleep apnea, restless legs syndrome, snoring, REM sleep behaviour disorder or even experience depression.

There are also medications that can affect sleep, including some used to treat dementia symptoms. Examples include pain relievers, drugs to treat Parkinson’s disease and antidepressants, so it’s important to speak with a doctor to find the best time of day to take medications if they are interfering with sleep.


What do these sleep problems lead to?

Insufficient sleep will lead to a lower quality of life. The person may become increasingly agitated, sleepy, have troubles focusing, fall over or have mood problems. They may talk in their sleep, wake up often and may wander around during the night.

Wandering is of great concern for carers. It disturbs the carer’s sleep and may be a danger for the person with dementia. This means that the carer also has trouble getting enough sleep.


Sundowning

Sundowning is a phenomenon that results in increased agitation that occurs during the later part of the day and evening with those who have dementia. Some symptoms include confusion, anxiety, wandering, and vocal outbursts. If these behaviours persist into the night, sundowning can also disrupt sleep patterns, leading to insomnia and other sleep-related issues.

Several factors can contribute to the onset of sundowning. One significant aspect is the disruption of the circadian rhythm, or body clock, which is a common symptom of dementia. Additionally, factors like fatigue, depression, and pain may also play a role in exacerbating sundowning symptoms. 
 

What are the effects on the carers of people with dementia?

Caring for a loved one with dementia can be very rewarding but if the carer doesn’t get the physical and emotional support they need, the stress of caregiving can lead to a wide range of problems including depression, anxiety and burnout. Carers must always be ready to provide care, keep an eye on the person, assist with daily activities and much more. To help carers to function at their best, and give both a carer and a person with dementia a chance to recharge, there are a range of respite services available.
 

How can we help those with dementia sleep better?

There are some solutions being trialled to support people with dementia to sleep better, for longer, and at the best times. These include:

  • Keeping a consistent sleep schedule to synchronise circadian rhythm
  • Scheduling social activities - a research study found that people with dementia who participated in one to two hours of social activity per day showed improved night time sleep
  • If a person with dementia is dealing with an underlying issue such as pain, a sleep disorder, or depression, treating the condition may improve sleep. A doctor can help with exploring treatment options
  • Some medications used to manage dementia can interfere with sleep, so talk with a doctor about the best time of day to take medications

 

By understanding the impact dementia has on sleep, carers and healthcare professionals can better work with a person with dementia to address this challenging aspect of their lives.

 

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