Sleep Problems Understanding Dementia “My mum would get angry if we woke her up, so we let her stay in bed till lunchtime. By 9pm my wife and I wanted to sleep but my mum would be wide awake. She would yell and want attention until she eventually fell asleep at 4am – it was exhausting! So we started getting her up five minutes earlier every day and her body clock slowly adjusted. Now she wakes up at 8am and goes to bed at midnight. I can now go to work without falling asleep!” How are Dementia & Sleep linked? Sleep problems are common in older people and dementia can make this worse. Being able to sleep well gets harder as thinking skills are lost and dementia progresses.
What causes it? Physical causes • Medical and mental illnesses. • Side-effects of medication. • Sleep disorders such as sleep. apnoea (breathing diff iculties while asleep) and restless leg syndrome. • Not enough exercise during the day. • Going to bed hungry. Their environment • Being too warm or too cold. • Not enough exposure to light during the day. • Bedroom is too bright or noisy at night. • Changes to the environment. Poor sleep hygiene • Spending too much time in bed during the day. • Taking too many naps during the day. • Having too much stimulation before bedtime. • Taking too much caffeine or alcohol.
What can I do to help? During the day • Make sure they get plenty of exercise. • Do activities with them to prevent long naps. • Help them spend less time in bed. Most people only need 6-8 hours of sleep a night. • Get them up earlier so they spend less time in bed or keep them up later so they are tired before sleeping. • Have regular waking-up and bedtimes. • Avoid caffeine and alcohol. At bedtime • Give them a snack if they are hungry. • Have a warm bath or shower before going to bed. • Check the room is not too warm or too cold and they are used to it. • Massage their legs at bedtime or give them a back rub when they wake up during the night. • Try playing soft music at the bedside. • Lavender oil can be soothing and helps some people sleep.
What about sleeping pills? Sleeping pills should only be used if prescribed by a doctor. They only work for a short period of time so it is better to improve their sleeping and bedtime habits. Why does dementia get worse at sunset? Some people with mid-stage to advanced Alzheimer’s disease become agitated and pace around as the sun is setting. This is known as ‘sundowning’. To reduce agitation • Distract your loved one with one of these activities: - playing music they like - doing a craft activity - going for a walk - turning on the television • Close the curtains so they do not see the darkness outside. • Turn on the lights to brighten the room and reduce shadows. • Have less noise, confusion and fewer people around. • Try sitting them in a rocking chair or giving a gentle massage.
Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group. Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.
GRM.IE.10.0517