Oct 30, 2015

8 Dementia Care Tips When Patient Has Problems Sleeping

What to do when an Alzheimer patient is not sleeping.


She had Alzheimer’s disease and had a lot of difficulty staying asleep all night | Alzheimer's Reading Room
By Rachael Wonderlin
Alzheimer's Reading Room

I once worked with a woman who had odd sleeping habits. She had Alzheimer’s disease and had a lot of difficulty staying asleep all night.


Throughout the night, she would wake up maybe two to five times. On a five-time night, it was tough. She had a motion sensor under her bed that would sound when her feet hit the floor. Ding, dong. Ding, dong. It was loud and sounded like a doorbell. Ding, dong.


Thanks to my challenging hours during graduate school, the only time I could work was at night. I’d go to her house around 8:00 PM, help her get ready for bed at 10:00 PM, and then go to sleep myself.


Throughout the night, she would wake up maybe two to five times. On a five-time night, it was tough. She had a motion sensor under her bed that would sound when her feet hit the floor. Ding, dong. Ding, dong. It was loud and sounded like a doorbell. Ding, dong.

I can still hear the noise in my head when I think about it, because it always shook me out of sleep in the most dramatic way.

In fact, it was tough to sleep there at all. My brain was on high alert, even as I dreamed: would she need my help tonight?

Alzheimer's and Not Sleeping


How often?

I tell you this story because I have a lot of respect for caregivers, especially those that provide 24-hour care for their loved ones. I also wanted to tell this story because I have personal experience caring for someone who is struggling with sleep.

The way to solve any challenging dementia behavior is this: find the root cause of the issue.


Dementia can cause a change in sleep patterns because of the way the brain is affected. There are ways to combat this, but first here are some questions you need to ask yourself:
  1. What types of medications is he on? Some medications can completely alter a person’s sleep cycle. Talk to your doctor about trying a vacation from some of his medications, or changing some of his prescriptions to see if it helps.
  2. When did this pattern start? What happened immediately prior to the change in sleep cycle?
  3. Is he depressed? Depression can have a profound effect on sleep. Many people who are severely depressed will sleep during the day and wake up at night.
  4. What did your husband do during the day in years past? Did he ever work third shift? He could be remembering this time in his life and feeling as though he has to be up for work.
  5. What does he do while he’s awake at night? Is he just watching TV and snacking, or is he trying to run errands?
  6. Does he seem aware that it is nighttime? If he seems confused about this, there are clocks that are made for people with dementia. The clock is big, bright, digital, and states that it is nighttime.
  7. Does he want to be up at night? I wonder if he’s feeling overwhelmed by everything that goes on during the day. Perhaps he finds nighttime more manageable and quieter.
  8. Have you tried environmental cues, such as leaving window shades open? If he notices that it is dark outside, maybe he will want to sleep.
Try to get your husband back on a more normal sleep schedule. Napping during the day can help solve this issue. See if he is able to wake up in the morning and then nap at the same time every day.

People with dementia are very schedule-oriented.

If he is able to nap for short periods during the day, perhaps he will still be able to fall asleep at night.

There are many ways to solve behavioral needs of people with dementia.

The first thing to do is to search for the root cause of the problem.

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*Rachael Wonderlin specializes in long term dementia care. She graduated from the University of North Carolina at Greensboro with a Master’s degree in Gerontology. She writes and answers questions from readers at Dementia By Day.

You are reading original content from the Alzheimer's Reading Room

Excerpt from a pervious article written by Rachael Wonderlin.

Don't Want to Lie to a Person Living with Dementia, Why Not Embrace Reality Instead

If there's one is one lesson that you can walk away with today after reading this article, it is this phrase:
“Embrace his or her reality.”

I once overheard a nurse arguing with a man who had dementia.

“That’s NOT your wife, you can’t come in here while we are getting Mildred *changed,” she said.

The more the nurse told him this, the more frustrated and angry he became.

“That is my wife. That’s my wife, let me in there!” he said, slamming his walker into the door.

Granted, Mildred was not actually his wife, but that was not the point. I walked up and put my hand on his shoulder. “Hey, let’s wait out here for her.

She’ll be ready soon,” I assured him.

He calmed down immediately and sat with me. I looked to the nurse and suggested that she avoid arguing with him. She became defensive and stated,

“I don’t want to lie to him.”

If there's one is one lesson that you can walk away with today after reading this article, it is this phrase:

“Embrace his or her reality.”


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