Sleep problems for people affected by dementia

Reviewed January 2021

• Practical advice on sleep problems for people with dementia

• Exercise, routines, medication

What can be done to help when people with dementia turn night into day and their carers cannot get a good night’s sleep? 

If you are living with someone who has this habit, life can be almost unbearable. Even if they are in another house, nocturnal phone calls and disturbances can cause chaos. Tempers are frayed and people get to the end of their tether without sleep. Some of these things are hard to talk about. Here are a few practical points that might help.

Exercise and dementia

Exercise is the most natural way of making someone tired and ensuring a good healthy sleep. A walk in the fresh air is a nice idea, but not always practical.   There are exercises you can do even from your chair and you can find out more about them here.   Daytime naps can be important for people with dementia who get extremely tired as a result of their condition, but if they are napping from boredom, it is more likely that they are going to be sleepless later. Try to get as much activity as possible happening in the daytime.

Bedtime routines and dementia

Whether you are a busy working person, a child or a person who is affected by dementia, bedtime routines are vital for all of us. Winding down and doing things that are recognisable clues that bed time has come are particularly useful for people who don’t feel tired or recognise that it is time for bed. You can do practical things like put away daytime objects and clothes. In some care homes now, staff at night wear night attire so that when people with dementia wake up, they find it easier to understand that it is still nighttime. Bright lights and staff wearing daytime clothes may give the impression to anyone that it is time to get up, even at midnight. The temperature matters. A cosy warm bed in a cool room makes it more likely that someone will stay under the bed clothes, even if they wake up.

Medication and dementia

Make sure that the person with dementia who has aches and pains is given their medication as prescribed, even if they seem not to need it at that moment. A person with dementia many not remember to take it, and they might not notice discomfort until they are lying down with nothing else to think about.  Any pain will wake them up in the night, waking the carer up as well.  Ask for medical advice about whether a small alcoholic drink is a good idea (it often depends on what medication the person is having).   Alcohol has a greater effect on older people, so one has to be careful.

Dementia and body clock

Everyone has a body clock that is affected by a hormone (melatonin) that is reduced in old age and even further in Alzheimer's disease. It is metabolised by exposure to daylight, particularly in the morning, so getting outside is really important during the day if you want someone to be sleepy at the right time.

Sleep deprivation and dementia

Sleep deprivation is a form of torture,  as any carer will tell you if they are looking after someone with dementia who turns night into day, but lack of sleep is also bad for the person with dementia.  If you are woken up night after night it can cause depression, indigestion, short temper, and make you vulnerable to illness.  You don’t need any of that especially when you are a carer. Fatigue can make it impossible to perform properly when you are working. It affects your mood and relationships. You need to find a solution. Medication might be prescribed by the doctor as a last resort. It often has side effects and can make the person more likely to have falls in the day time, due to a hangover from the previous night’s pills. So there are decisions to be made that cannot be taken lightly.

For further advice about getting a good night’s sleep look here for the UK edition or here for the North American one.

And if you have any further queries or questions, please contact me at info@juneandrews.net