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Sleep Problems and Dementia

Tuesday March 1, 2022

Sleep is a vital part of our overall health and allows our bodies to recharge. As a caregiver, you may have noticed big changes in your loved one’s sleep patterns. You may have even been awoken in the middle of the night to an unpleasant scene. Problems with sleep can include excessive daytime sleepiness, insomnia, waking up frequently in the night, and sundowning. Unfortunately, these problems tend to worsen as dementia progresses.

Factors that contribute to poor nighttime sleep:

  • Mental and physical exhaustion at the end of the day
  • Changes in Circadian rhythm
  • The natural need for less sleep with aging
  • Disorientation
  • Reduced lighting, which causes an increase in shadows
  • Feeling too hot or too cold
  • Pain

It is important to treat any underlying conditions first (e.g., restless leg syndrome, sleep apnea, depression, and pain).

Tips for better sleep:

  • Establish a routine.
  • Set a peaceful mood. Put on calming music or read a book out loud. Make sure the room temperature is comfortable and use night lights.
  • Encourage physical activity during the day, and limit daytime sleeping.
  • Limit TV watching at night.
  • Avoid alcohol, caffeine, and nicotine.
  • If your loved one is taking a prescribed cholinesterase inhibitor, such as Donepezil, avoid giving it right before bed.
  • Ask your loved one’s doctor if medications they are taking could be affecting sleep or if Melatonin might be right to add to the bedtime routine. It is important to communicate with a physician about sleep problems because sleep problems can affect your whole household.

While it may be tempting to argue with your loved one about going back to bed, this just feeds negative feelings. Try to find out if there is a cause to their waking. Do they need to use the bathroom, or are they in pain? They may simply need to pace in their room and should be allowed to do so if they can remain supervised.

Nighttime wakefulness is extremely common according to the Alzheimer’s Association. They estimate that “in the late stages of Alzheimer’s, individuals spend about 40 percent of their time in bed at night awake and a significant part of their daytime sleeping.” That’s right. Almost half of their time in bed is spent being awake. It’s no wonder that they want to sleep so much during the day.

It is important that you have safety measures in place in your home to prevent a tragedy while you sleep.

  • Install a home alarm that will beep when a door or window opens.
  • Store all matches, lighters, weapons, and medications in locked storage.
  • Consider a baby monitor with video so you can hear and see movement in their room.

Know that you are not alone. Reaching out for help is a sign of strength, not weakness. Support groups can be a source of emotional support as well as tips and tricks that others have tried. Communicate with family members, who can take turns sharing the load so that you can get some rest.

Sleep is a necessity, not a luxury. Take this as permission today to take steps toward a better night’s rest for you and your loved one. 


Written by Rebecca Surbrook, RN