Alzzzzzzheimer’s: Sleep and Dementia

i love sleeping

Unfortunately for the 15 million caregivers and 5.2 million living with Alzheimer’s disease (AD), sleep disturbances are a common occurrence among those with dementia. These disturbances can diminish the caregiver’s and care recipient’s quality of life. Research indicates that nearly half of those diagnosed with Alzheimer’s will exhibit disrupted sleep (Salami, Lyketsos, & Rao, 2011) at some point during their illness.  In AD, sleep disturbances are typically characterized by waking up throughout the night, daytime napping, and daytime drowsiness (Salami, Lyketsos, & Rao, 2011). Lack of sleep or poor sleep quality can also cause disorientation, confusion, and disordered thinking during the day, compounding the cognitive symptoms the person may already be experiencing. Furthermore, sleep disturbances, “increase the risk of physical and psychological morbidity in the persons with dementia and their caregivers” (McCurry et. al., 2011, p.1393) and increase the likelihood of institutionalization.

Sleep is clearly a prevalent issue in AD, but how do we overcome these challenges? More research is needed to effectively answer this question, but below are some evidence-based recommendations that might assist in promoting regular, good quality sleep.

Non-Drug Interventions

  • Maintain regular times for getting to bed and arising.
  • Establish a comfortable, secure sleeping environment — reduce noise or other stimuli, make sure bedding and room temperature are comfortable, provide nightlights and/or security objects.
  • Discourage staying in bed while awake or watching television while in bed; use the bedroom only for sleep.
  • Increase sunlight exposure during the day.
  • Have the person avoid excessive evening fluid intake and empty the bladder before going to bed.
  • Avoid daytime naps if the person is having trouble sleeping at night.
  • Treat any pain symptoms.
  • Engage in regular daily exercise, but no later than 4 hours before bedtime.
  • If the person is taking cholinesterase inhibitors (e.g. Exelon, Aricept) avoid giving the medicine right before bed

sleep

Final Thought

If you notice disturbed sleep in the person with dementia, it may be helpful to have a physician, such as a neurologist, give his opinion. Medication side effects, chronic illnesses, mood disorders, etc., could be contributing to the problem, and a medical doctor is best to address these issues.

References

Cole, C., & Richards, K. (2005). Sleep and cognition in people with Alzheimer’s disease. Issues In Mental Health Nursing26(7), 687-698.

McCurry, S. M., Pike, K. C., Vitiello, M. V., Logsdon, R. G., Larson, E. B., & Teri, L. (2011). Increasing Walking and Bright Light Exposure to Improve Sleep in Community-Dwelling Persons with Alzheimer’s Disease: Results of a Randomized, Controlled Trial. Journal Of The American Geriatrics Society59(8), 1393-1402. doi:10.1111/j.1532-5415.2011.03519.x

Salami, O., Lyketsos, C., & Rao, V. (2011). Treatment of sleep disturbance in Alzheimer’s dementia. International Journal Of Geriatric Psychiatry,26(8), 771-782. doi:10.1002/gps.2609

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