Alzheimer’s Sleep Problems
Sleep Troubles for People with Memory Loss
Many people with Alzheimer’s disease or other types of dementia face sleep problems. They may have trouble falling asleep, wake up several times during the night, or get up too early in the morning. Some feel sleepy during the day or have disturbed and broken sleep at night.
“Sundowning” often causes confusion or restlessness in the late afternoon or at night. This can lead to anxiety, fear, or aggression. Night wandering also poses risks if someone leaves their room or home unnoticed. People with Alzheimer’s more often have breathing problems at night, like sleep apnea, where breathing stops and starts, making sleep less restful. Restless legs can also make sleep harder. Several factors can make these problems worse:
- Feeling tired after a long day.
- Changes in the internal clock, which tells the body when to sleep or wake.
- Needing less sleep with age.
- Sleeping in a new or confusing room.
- Low lighting and long shadows, which may cause fear or confusion.
- Pain, hunger, or thirst that interrupts sleep.
Table: Common Sleep Patterns with Dementia
| Sleep Issue | Description |
|---|---|
| Fragmented sleep | Waking up often during the night. |
| Excessive daytime sleepiness | Feeling tired during the day. |
| Sundowning | Late-day confusion, restlessness, or anxiety. |
| Obstructive sleep apnea | Breathing problems that disrupt sleep. |
| Night wandering | Getting up and moving around when others are asleep. |
| Trouble falling asleep | Difficulty starting to sleep at bedtime. |
Ways to Improve Nighttime Rest
Several strategies can help both people with dementia and their caregivers get better sleep. Small changes in daily routines and environments can make a big difference.
1. Address Other Health Issues: Check if problems like depression, sleep apnea, or restless legs are part of the sleep problem, and get help if needed.
2. Keep Regular Schedules: Set times for waking, eating, and going to bed every day. Routines help shape healthy sleep patterns and support the body’s internal clock.
3. Avoid Stimulants: Skip caffeine, alcohol, or nicotine, especially in the evening. These make falling and staying asleep harder. Avoid TV and phones before bed and during the night, as electronic devices can be stimulating.
4. Encourage Daytime Movement: Physical exercise, like walking, helps people sleep better at night. Getting outside in the sunlight supports better sleep by strengthening natural sleep-wake cycles.
5. Limit Daytime Naps: Long naps during the day can make it harder to rest at night. Keep any naps short and avoid them late in the day.
6. Create Calming Evenings: Wind down before bed by reading aloud, listening to soft music, or relaxing together. A peaceful evening routine can reduce anxiety.
7. Adjust Medications if Needed: Some medicines for mood or memory can keep people awake. If sleep problems start after a medication change, talk to the healthcare provider about adjusting the timing.
8. Try Melatonin or Light Therapy: Melatonin, a sleep hormone sold as a supplement, may help. Bright light therapy, using special lamps or light boxes in the morning, can help reset the sleep cycle.
9. Provide Gentle Lighting: Soft lights at night can lower anxiety caused by darkness and reduce the risk of falls. Daylight during the day helps the brain know when it should be awake.
List: Quick Evening Checklist for Better Sleep
- Set regular bed and wake times.
- Avoid caffeine, alcohol, and nicotine in the evening.
- No TV, phones, or tablets close to bedtime.
- Exercise during the day.
- Calm activities before bed.
- Comfortable bedroom: quiet, cool, and dimly lit.
- Address pain, hunger, or thirst before sleep.
What to Do If Someone Wakes Up at Night
People with memory loss often wake up during the night. If this happens, stay calm and gentle, even if you feel frustrated or tired. Instead of arguing, ask what the person needs. Check for signs of discomfort, like needing the bathroom, being too hot or cold, or being in pain.
Gently remind the person that it is nighttime. If they need to walk around, make sure the environment is safe and let them pace if it helps. Help the person relax again to restore sleep. Try gentle words, adjust blankets, or offer water if needed.
Possible Reasons for Nighttime Wakefulness
- Full bladder
- Constipation
- Room is too warm or cold
- Pain or discomfort
- Hunger or thirst
- Bad dreams or confusion
Considering Sleep Medication
If changes to daily habits and routines do not help enough, a healthcare provider might suggest sleep medicine. Use caution with sleep medicines for older adults and those with dementia. These drugs can cause confusion, unsteadiness, and increase the risk of falls. Caregivers and healthcare providers often recommend trying lifestyle changes first.
If medicine is needed, use the smallest dose for the shortest time possible. Sleep aids may help set a regular sleep pattern, but they are not for long-term use. Side effects can include drowsiness during the day, feeling groggy, or more memory trouble.
Table: Risks and Tips for Sleep Medication Use
| Risk | How to Manage |
|---|---|
| Dizziness or confusion | Use medicines only if really needed; monitor closely. |
| Increased chances of falling | Create a safe environment; supervise nighttime walking. |
| Daytime drowsiness | Use the lowest possible dose; avoid using it every night. |
| Memory or behavior problems | Report all changes to the doctor or nurse. |
If someone starts sleep medicine, review it regularly. The goal is to stop it once sleep improves.
Caregivers Must Rest Too
Caring for someone with Alzheimer’s or dementia is exhausting, especially when sleep is disrupted at night. Tired caregivers can feel stressed, anxious, or even sick. Ask for help when needed. Family, friends, or professional caregivers can sometimes watch over a loved one overnight. Talk to a healthcare provider, social worker, or local support group for extra help or advice.
List: How Caregivers Can Get More Sleep
- Share nighttime care duties with others, if possible.
- Take naps during the day when the person with dementia is resting.
- Seek respite care or professional help if needed.
- Be honest about your limits with your family and care team.
- Contact local resources or support organizations for assistance.
Caregivers should remember that their own health and safety matter. Rest helps them provide better care and support for their loved ones.
