Sleep

How to manage sleep problems caused by dementia

A person with dementia may struggle to sleep properly at night and may need more sleep during the day. They may also wake frequently at night and be prone to wandering.

Confusion can be a common reason for night-time wandering. If a person wakes up and doesn’t know what time it is, they may assume it is time for them to get up or do something, such as get dressed and go to work. If they are older and retired, they may think they are still working. 

What generally causes sleep problems in a person with dementia?

Physical changes in the brain caused by dementia can lead to sleep problems. Our bodies tend to sleep in cycles from light sleep to deep sleep and then dream sleep (also called Rapid Eye or REM sleep). People with dementia spend less time in deep sleep and this tends to get worse as their dementia progresses. 

Another reason for sleep disturbances can be a reduction in the sleep hormone, melatonin, which is produced by the brain and helps us sleep. 

Other more specific causes of sleep problems include being in pain or possible side effects of medication. 

A person with dementia can also find normal daily tasks that most of us take for granted tiring, meaning they may need more sleep during the day. Processing information, formulating words and absorbing what is being said in a conversation can be exhausting for someone with dementia.  

Confusion between night and day

Confusion at night can occur more frequently in the summer. The part of our brain that serves as our internal clock and responds to cues, such as light, can be impaired in a person with dementia.

As their dementia progresses, the person may confuse 5am with 5pm for instance, in the summer when it gets light earlier. 

Poor nutrition can also affect the person’s general energy levels, making them need to sleep more than usual. Try to limit or reduce the amount of sugary snacks they have later in the day, which can stimulate them, and minimise caffeine intake if possible. Offer the person herbal tea or a warm milky drink before bedtime rather than hot caffeinated drinks.

There are some other ways you can combat poor sleeping habits by making some simple lifestyle changes. 

• During the day, encourage the person to have a walk or do some other form of activity if they can. If the person cannot exercise or isn’t mobile, encourage them to spend some time in natural daylight. This has been known to help with sleep.

• If the person doesn’t want to go outside, even arranging for them to sit next to an open window or doorway may help.

• Although the person may want a daytime nap, try not to ensure they don’t sleep for too long, as this may make it more difficult for them to sleep at night. Try to keep naps limited to an hour.

• Develop a bedtime routine for the person. Dementia UK recommends turning the TV off an hour before bed and getting the person to put away mobile phones or other digital devices if they use them. 

• Make sure the person’s bedroom temperature is comfortable and not too hot and not too cold. Ensure they are wearing comfortable nightwear. 

• If the person tends to wander at night, leave a hallway light on and leave the bathroom door open so that they can easily find their way to the toilet.

• However, if the person has been sleeping more than usual and this is a recent change, it’s important for them to seek medical advice, as a health issue, such as an infection, could be causing the change.