Are you taking care of a loved one who endures dementia? You may have noticed variations in his or her sleep patterns as the disease has progressed. Scientists do not fully understand why dementia affects a person’s sleep cycle, but due to dementia’s significant effects on the human brain, a substantial percentage of sufferers endure sleep disturbances.
Brain Damage Due To Dementia
Dementia characterizes by cell death and tissue loss in the brain, causing the brain to shrink and preventing its functions. The cortex, which is the portion of the brain associated with thinking, and the hippocampus, which is an area of the cortex related to the accumulation of memories, endure a dramatic loss in size. Meanwhile, the ventricles, which are the void cavities in the brain that fill in with fluid, increase in size.
Unfriendly plaques and tangles accumulate in a brain with dementia and may be the reason of the cell and tissue death. Tangles can devastate a vital cell transport system made up of proteins. In a healthy brain, proteins keep food molecules and other crucial materials on track to their destination, but in mind with dementia, these helper proteins fall into tangles that no longer control the transport system. Because they can no longer get nutrients, the cells ultimately die.
The changes to a brain with dementia affect all areas of life, including sleep. Although these changes are more apparent in later stages, they may also become noticeable in earlier stages.
Difficulty Sleeping. Sufferers may take longer to fall asleep, frequently wake during the night, and disturb those around them when they wake up confused. They spend less time dreaming and also non-dreaming stages.
Daytime Napping. Variations in the sleep-wake cycle may result in people with dementia feeling tired throughout the daytime but unable to fall asleep at night. If a person spends a meaningful amount of time lying in bed awake at night, they are more likely to consume much of their day napping.
Nighttime Wandering. It is common for people with dementia to wander away, which causes stress for caregivers who must always be on their guard. If a person with dementia has a disordered sleep cycle, this restless habit can take place in the middle of the night.
Sleep-Disordered Breathing. When an individual snore at night, the long, loud breaths punctuated with intervals of no breathing. Depending on the sharpness of the breathing disorder, a person may stop breathing many times per hour, discontinuing the flow of oxygen to the brain. Studies imply a connection between snoring and memory-loss, ending in a condition called Mild Cognitive Impairment.
Sundowning. A syndrome that afflicts many sufferers of dementia, sundowning is identified by mood swings later in the day. A person might feel happy and calm during the day until around 4 pm when they become hostile or aggressive. They may shout or pace, and they have difficulty calming down enough to sleep until late at night.
What Is Causing Those Sleep Changes?
Whether medical or environmental, it is essential to identify the causes of sleep changes. Speaking with a medical professional may aid you in your search for sleep relief. It is particularly crucial to determine the reasons for difficulty sleeping with people living with dementia, as they may not be provided to identify the problem themselves.
Depression. Depression, for which the symptoms include apathy, isolation, and difficulty concentrating, is incredibly common among those who have dementia, particularly in the early to middle stages. Although depression in people with dementia does not always display the same symptoms that it does in non-dementia subjects, it may result in sleep disturbance. Treating depression in people with or without dementia requires serious consideration.
Restless Legs Syndrome. It is listed as a sleep disorder because periods of inactivity or sleep cause its symptoms. When a person suffers from this disease, uncomfortable sensations in the legs occur creating an overwhelming desire to move them. The awkward feeling subsides when the subject walks around but then resumes when he or she tries to lay down again. Due to the disorder making it so tough to sleep, most sufferers of Restless Legs Syndrome become drowsy and irritable all day long.
Sleep Apnea. A severe sleep disorder, sleep apnea is a frequent cause of snoring and results in momentary pauses in breathing that occur many times throughout the night. It means the brain is not getting enough oxygen and raises a person’s risk for depression, heart problems, diabetes, and stroke. There are two distinct types of sleep apnea: Obstructive Sleep Apnea and Central Sleep Apnea. The cause of this is a physical blockage of the airway, and the following results when the brain does not tell the muscles tissues to breathe.
Urinary Tract Infections. Often generated by the presence of E. Coli or other bacteria in the urinary tract, urinary tract infections are sadly quite common among women, and they can also affect men. UTIs are known to cause a frequent desire to urinate, which disturbs the sleep cycles and makes sufferers go to the bathroom in the middle of the night.
Experiencing Disorientation After Dream. People with dementia may become confused when waking at night, as they have difficulty distinguishing between dreams and real life. If they awake from a dream that took place through the day, they may think that it is still daytime getting out of bed, even though it is the middle of the night.
Less Need for Sleep. Many seniors require less sleep than younger people. It may result in them waking up with higher frequency during the night. It is due to the death of regulatory neurons correlated with regular sleep patterns in aging people.
An Upset in the Body’s Circadian Rhythm. Many seniors feel less satisfied with their sleeping patterns, due to changes in their circadian biological clock. This system tells us when we should be awake and when we should fall asleep, triggered by signals sent from the body and light and dark conditions outside. For this reason, many elderlies sleep quite early in the evening and wake much earlier in the day. Dementia can exacerbate this uncertainty about sleeping and waking hours as it harms the brain.
How To Help A Loved One To Endure Sleep Problems
Although no one answer will be a cure-all for sleep problems, there are ways to alter the sleeper’s atmosphere that may help ameliorate the situation.
Formulate environmental cues to signal waking and sleeping hours. During daytime, this means exposure to bright light. People with dementia should spend at least an hour outdoors exposed to the sun’s light. If their physical condition makes going out for this length impossible, bright light treatment with specially intended lamps can work as a substitute.
At night, you may consider installing blackout curtains in the bedroom where a person with dementia sleeps to prevent outside lights from sending disturbing signals about the time of day. Other people in the house should avoid making noise. Furthermore, a clock near the bed that shows the time of day and whether it is day or night can help guide a disoriented person who wakes during the night.
Create a tranquil sleeping environment. Temperature, bedding, and sound are all critical for ensuring the sleeper get the best potential rest. Make sure the place where they are sleeping is not too hot or too cold, and their bedcovers are clean and comfortable. Also, outside noise can have a significant impact on sleep quality. If you live in a noisy area, consider placing a white noise machine to cancel out sounds. Finally, you may wish to place night lights to guide the person to the bathroom, just in case they wake in the middle of the night.
Establish a steady routine. To aid the body’s regular circadian rhythm, establishing a set wake-up time and bedtime can produce better sleep habits for people who cope with sleep problems. It is particularly important to develop a set wake-up time, as this will enable the body to exhaust naturally in time for bed in the night.
Increase outdoor physical activity throughout the day. Taking an individual with dementia for a walk is twice useful in combatting sleep dysfunction: an outdoor hike both gives a person a chance to use their muscles and consume energy, and it raises their exposure to sunlight. These actions in tandem help a person feel easily tired at the end of the day and sustain his or her internal clock.
Regulate your loved one’s diet. Caffeine and alcohol both adversely affect the quality of sleep, mainly if consumed in the hours before bedtime. Caffeine makes a person awake and alert. Furthermore, studies imply that alcohol impedes the restorative functions of sleep. Large, sugary meals before bedtime can also make it more difficult to fall asleep. As with anyone, a healthy diet ends in a more youthful person, and it can be especially critical to avoid certain unhealthy foods in the cases of dementia patients. They should also prevent nicotine, which is another stimulant like caffeine.
Install a nighttime monitor. For your peace of mind, placing a monitor in the room of a sleeping loved one with dementia can let you know if they have woken. If he or she has woken up and is disoriented about the time of day, you should stop them from lying in bed awake. Make sure that the bed relates with sleep. Likewise, deter them from watching TV during these episodes.
Medications As A Solution
If all else does not seem to help a person living with dementia sleep well, you may consider sleep medications. However, be aware that sleep-aids bring with them a significant risk and should be a last resort. The risks include a risen chance of falling and subsequent bone fractures, increased confusion, and a further decline in the capacity of the person to take care of him or herself. If a person establishes a healthy sleep pattern through using sleep medications, it is best to try and wean them off the drug.
A doctor may prescribe a drug basing on the responses which come with the sleep disturbances. Common prescriptions to help cognitively impaired older adults obtain healthy sleep patterns are nonbenzodiazepines, antidepressants, benzodiazepines, and antihistamines. Doctors may work in some cases to order antipsychotics, although the risk of severe adverse side effects is quite high. The FDA recommends seeking other treatments above the use of this kind of drug.
Benzodiazepines and nonbenzodiazepines. These medications are a variety of sedative-hypnotic agent and doctors frequently prescribe them for short-term therapy of unhealthy sleep patterns. Benzodiazepines raise total sleep time while decreasing the amount of time spent in superficial sleep stages. Like all sleep aids, there is a peril of side effects like increased drowsiness, confusion, and forgetfulness, especially in older adults who have dementia. Newly developed benzodiazepines may have fewer side effects, but because of their newness, researchers lack the data to know for sure.
Antidepressants. Often appointed when doctors believe irregular sleep patterns to be a byproduct of depression in older adults, antidepressants are efficient in inducing healthy sleeping habits. However, adverse side effects in elderly dementia patients involve drowsiness, sedation, dizziness, and weight gain. In this level, doctors most regularly prescribe selective serotonin reuptake inhibitors.
Antihistamines. Most over-the-counter sleep aids comprise antihistamines, and doctors often prescribe them to elderly dementia patients. Antihistamines work versus naturally occurring histamine produced by the central nervous system. However, users of antihistamine grow a tolerance quickly, and its sedative effects may not last long. Moreover, antihistamines trigger many antagonistic side effects in older adults, such as drowsiness, confusion, hallucinations, urinary retention, and others. Not recommended due to these side effects.
Dementia takes a severe toll on those whom it torments and on that person’s caregivers. Making sure that a dementia patient gets a good night’s sleep can offer some peace of mind to everybody involved in the care. As sleep disruptions in dementia patients are quite usual, a physician will most likely be able to advise you on how to higher the length, consistency, and quality of sleep. Often, changes in the environment and behavioral habits will be sufficient to improve sleeping patterns, and patients can avoid riskier medical solutions.
Watch a video about Dementia and Problems with Sleep.