Posted by: Bert Copple | September 11, 2013

Losing Sleep Over Alzheimer’s

unmade bedFor many families, Alzheimer’s would be more aptly named All-the-timer’s:  it doesn’t follow the clock. Which may be why, at least when it comes to sleeping, some people with Alzheimer’s don’t either.

At Home Instead Senior Care serving the Detroit metro, Oakland County, Macomb County, Wayne County, and Southeast Oakland County, we have worked with a lot of clients with Alzheimer’s who simply can’t sleep at night, whether it’s due to getting up repeatedly, evening behavioral problems, a.k.a. “sundowning,” sleeping at odd hours or night terrors.

According to the Alzheimer’s Association, experts estimate that in late stages of Alzheimer’s, individuals spend about 40 percent of their time in bed at night awake and a significant part of their days sleeping. In extreme cases, people may have a complete reversal of the usual daytime wakefulness-nighttime sleep pattern. Some of the causes for this include:

  • End-of-day exhaustion (both mental and physical)
  • An upset in the internal body clock, causing a biological mix-up between day and night
  • Reduced lighting and increased shadows causing people with Alzheimer’s to misinterpret what they see, and become confused and afraid
  • Reactions to nonverbal cues of frustration or exhaustion from those caring for them
  • Disorientation due to the inability to separate dreams from reality when sleeping
  • Less need for sleep, which is common among older adults

Of course this also results in a poor night of sleep for anyone caring for a loved one with Alzheimer’s – a deficit that, over time, can lead to long-term exhaustion, enhanced stress, depression and other health issues.

But there are some things you can do to reduce your senior’s wakefulness in the night.

  • Make sure your senior’s home is well lit. Adequate lighting can help reduce the agitation, disorientation or confusion a senior might feel in a dark or seemingly unfamiliar environment.
  • Keep a schedule. Routine is important to people with Alzheimer’s. By trying to maintain daily mealtimes and bedtimes, you can help them feel more secure about what needs to happen when.
  • Avoid stimulants. It probably goes without saying that alcohol and tobacco products are best avoided, but also restrict sweets and caffeine consumption to the morning hours and keep the evening meal light.
  • Keep the early part of the day active. Fill the mornings and early afternoons with any bathing, medical appointments, exercise and outings and discourage napping, then begin winding down as evening approaches.
  • Identify triggers.  Pay attention to the patterns in your senior’s environment. If a loud television, having visitors or extra people around or the activity surrounding evening meals seems to set them off, then how can these things be avoided?

If your senior is experiencing sleep loss due to Alzheimer’s, these are some precautions to keep your senior safe and the evenings less eventful.

  • Make sure there is a nightlight in your senior’s room and consider installing rope lighting in any hallways or pathways to the bathroom or other rooms your senior frequents. Also, keep the floor free of tripping hazards.
  • Make sure any windows, outside-leading doors and medicine cabinets are locked.
  • Remove or hide any troublemaking items. For example, if a senior has a habit of stuffing objects in the toilet, remove these items from the bathroom before going to bed. If toilet paper is an issue, leave enough for your senior to use if needed once or twice but not enough to clog your system.
  • Discourage TV, night eating and other activities that will stimulate your senior and keep them up longer.

For more information, please call us at 248-203-2273, visit our website, or Like us on Facebook.

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