Why Dementia Can Cause Sleep Disturbances

Sleep difficulties are not unusual among dementia patients. Dementia is associated with sleep disorders, and sleep disorders may indicate the development of dementia.

How Dementia Affects the Brain

Alzheimer’s patients experience neuronal degeneration. Degeneration causes damage to the basal forebrain and reticular formation of the brain stem. It’s in these two regions that sleep patterns are regulated. When these areas of the brain are damaged, it can lead to changes in sleep patterns.

Changes in sleep patterns are sometimes one of the first indications of degenerative brain disease. People with Alzheimer’s disease have a higher rate of presence of beta-amyloid plaques in their brains, which clump together and collect between neurons and disrupt cell function. Insomniacs and seniors who suffer from sleep problems often have a higher rate of these plaques than people who have healthy sleep.

What Dementia Does to Sleep

Living with dementia can lead to sleep-wake rhythm disturbances. Dementia patients may fall asleep frequently during the day, or wake up during the night. Circadian disruption may change as brain disease progresses. Typically, dementia patients experience a rapid decline in circadian rhythm, then return to stronger rhythms for a short period before declining further in late stage dementia. Circadian rhythm decline in dementia may be due to difficulty in recognizing environmental cues.

Common sleep difficulties among dementia patients include:

  • A decrease in total sleep time
  • A decrease in sleep efficiency
  • Nighttime wandering, confusion, and agitation
  • Increased daytime sleepiness
  • Longer sleep latency

How Dementia Patients Can Sleep Better

Sleep is often difficult for dementia patients, and it typically does not get better in the long term as brain disease progresses. However, caregivers can support healthy sleep to help dementia patients get the best sleep possible.

  • Make sure their sleep environment is safe. Dementia patients may wander at night or fall out of bed, which can be dangerous. Make sure there are soft, dim nightlights available to guide their path at night and check all doors and windows to be sure they are closed and locked.
  • Create a comfortable sleep environment. Ensure that dementia patients are sleeping in an environment that supports rest. Their bedroom should be kept dark at night, a comfortable cool temperature, and with minimal noise. Be sure that they are sleeping on a mattress that meets their needs. Mattress reviews can provide insight into what may work for them.
  • Avoid stimulating nighttime activities. Watching loud TV at night, drinking coffee, eating a heavy meal, and other stimulating activities can interfere with sleep. Avoid these at night.
  • Maintain daytime activities. Dementia patients are often sleepy during the day, but when they are awake, make sure they’re getting plenty of activity to stay stimulated and maintain a more normal circadian rhythm. Spend time doing exercise, such as walking the halls of their living facility, or mentally stimulating activities such as knitting, reading aloud, or talking. Make sure they spend time out of their room and avoid letting them stay in their bed all day. Ideally, their bed should only be used for rest.
  • Time naps carefully. Dementia patients may nod off, but if it’s possible to time their naps, do so. Naps should be avoided in the evening, as this can make them too well rested to sleep. Avoid late afternoon napping if possible.
  • Use light exposure. Dementia patients may spend much of their day indoors without exposure to bright light. This confuses their circadian rhythm, telling the brain that it’s nighttime and time to wind down and sleep. If dementia patients get exposed to light, the opposite cue is sent to the brain, telling the brain that it’s daytime and time to be awake and alert. Spend time outdoors in the sun, open windows, and turn on bright lights during the day to reinforce these environmental cues. A light therapy box can be used as well.
  • Maintain a regular sleep schedule. Keep a regular schedule for dementia patients, going to bed at the same time and waking up around the same time each night and day. You can create a regular bedtime routine that helps them wind down at night as well. And keeping a regular schedule throughout the day, such as meals and activities, can add a sense of comfort and regularity as they know they can predict what’s coming next, including sleep.