Dementia Patients: Sleeping All Day, Good Or Bad?

Sleep is essential for our well-being, and this is no different for people living with dementia. However, it is common for people with dementia to experience sleep problems, which can impact their daily lives and result in behavioural changes. This can be distressing for both the person with dementia and those close to them. So, what can be done to help manage sleep for people with dementia?

Excessive sleep as an early sign of dementia

Excessive sleep may be an early sign of dementia. A 2017 study found that participants who slept more than nine hours per night were at higher risk for developing Alzheimer's disease. This could be a sign of deterioration in the regions of the brain responsible for sensing light and waking the brain up at the appropriate times.

However, it is important to note that excessive sleep can also be caused by other factors, such as sleep disorders, medication, or other health conditions. If you or a loved one is experiencing excessive sleep, it is recommended to speak to a doctor to rule out any other potential causes.

• The progression of the disease: As dementia progresses into the later stages, the damage to the person's brain becomes more extensive, and they may find it exhausting to perform simple tasks such as communicating or eating. This increased exhaustion can lead to more sleep during the day.
• Type of dementia: Certain types of dementia, such as vascular dementia, dementia with Lewy bodies, or Parkinson's disease dementia, are associated with excessive daytime sleepiness.
• Medication: Antipsychotics, antihistamines, and antidepressants can cause drowsiness and contribute to increased sleep.
• Sleep disorders: Conditions such as sleep apnea or insomnia can disrupt sleep patterns and contribute to excessive sleep.

The impact of sleep on the brain

Sleep has a significant impact on brain function, influencing various cognitive processes and overall brain health.

Firstly, sleep is essential for memory consolidation, which is the process of reinforcing new information in the brain so that it can be recalled later. Both non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep play distinct roles in this process. NREM sleep is associated with declarative memory, which involves basic facts and statistics, while REM sleep boosts procedural memory, such as remembering a sequence of steps. When sleep is disrupted or insufficient, memory consolidation is impaired, leading to difficulties in learning and remembering.

Secondly, sleep supports other cognitive functions, including attention, concentration, problem-solving, creativity, emotional processing, and judgment. A well-rested brain can effectively coordinate these processes, promoting sharper thinking and improved performance in tasks requiring focus and mental agility. Conversely, sleep deprivation or poor sleep quality can result in excessive sleepiness, poor attention span, reduced adaptability, impaired emotional capacity, and compromised judgment.

Additionally, sleep plays a crucial role in brain health and the prevention of cognitive decline. Chronic sleep deprivation or poor sleep has been linked to an increased risk of dementia and Alzheimer's disease. During sleep, the brain clears out potentially harmful beta-amyloid proteins. Sleep deprivation can lead to an accumulation of these proteins, forming plaques that worsen cognitive function and increase the risk of Alzheimer's disease.

Moreover, sleep has a regulatory effect on hormones that control feelings of hunger and fullness, such as leptin and ghrelin. Sleep deprivation can disrupt the balance of these hormones, leading to increased appetite and a higher risk of weight gain and obesity.

Finally, sleep is necessary for the proper functioning of the central nervous system, which is responsible for transmitting information throughout the body. Sleep deprivation can disrupt the normal signalling pathways in the brain, affecting coordination and increasing the risk of accidents.

In summary, sleep has a profound impact on the brain, influencing memory, cognitive function, emotional processing, hormone regulation, and overall brain health. Adequate and high-quality sleep is essential for maintaining optimal brain function and preventing cognitive decline and neurological disorders.

The importance of a healthy sleep routine

Sleep is essential for everyone, but it becomes even more critical for individuals living with dementia. Establishing a healthy sleep routine can significantly improve the quality of life for people with dementia and their caregivers. Here are some reasons why a healthy sleep routine is crucial:

Improved mood and energy levels:

A good night's sleep is vital for regulating mood and energy levels. For individuals with dementia, a healthy sleep routine can help improve their mood, reduce agitation and confusion, and increase their energy levels during the day. A well-rested person with dementia is more likely to engage in activities and social interactions, which can enhance their overall well-being.

Enhanced cognitive function:

Sleep plays a crucial role in cognitive function, including memory, attention, and problem-solving. A healthy sleep routine can help individuals with dementia maintain their cognitive abilities for a more extended period. Adequate sleep also supports brain health and may even slow down the progression of dementia in some cases.

Better physical health:

Sleep is essential for physical health, and this is particularly true for people with dementia. A healthy sleep routine can improve their overall physical health, reduce the risk of falls and other accidents, and help maintain their strength and mobility. Additionally, a well-rested body is better equipped to fight off infections and illnesses, which is crucial for individuals with dementia, who may have weakened immune systems.

Reduced risk of other health issues:

Disturbed sleep patterns and excessive daytime sleepiness are often associated with other health issues. Maintaining a healthy sleep routine can help reduce the risk of developing conditions such as sleep apnea, restless leg syndrome, and even depression. Addressing sleep issues can also help manage other coexisting conditions that may be contributing to sleep disturbances.

Improved quality of life for caregivers:

Caring for an individual with dementia can be physically and emotionally demanding. When the person with dementia has a healthy sleep routine, their caregiver can also get better rest and have more energy during the day. This can lead to improved caregiving and a better quality of life for both the person with dementia and their caregiver.

In conclusion, a healthy sleep routine is of utmost importance for individuals with dementia and their caregivers. It can improve their overall health, enhance their quality of life, and even slow down the progression of dementia in some cases. By prioritising sleep and implementing strategies to improve sleep quality, caregivers can make a significant difference in the lives of those living with dementia.

How to help dementia patients sleep better at night

Sleep problems are very common for people with dementia. They can include sleeping during the day and being awake and restless during the night, becoming disoriented in the dark, and getting up in the early hours and thinking it's daytime.

• Treat any underlying conditions: Reduce any pain or discomfort with painkillers, gentle heat, or massage before bed. Ask your pharmacist if you are worried that any drugs the person is taking might be contributing to their sleep problems.
• Establish a daytime and bedtime routine: Do regular activities at the same time each day. For example, go out for a walk after breakfast, play a game after lunch, or listen to the radio together in the afternoon. This will provide a familiar routine that helps the person make sense of the time. Keeping a routine for the hour or so before getting into bed should also encourage feelings of sleepiness.
• Set a sleep-friendly environment: Make sure the bedroom is quiet, dark, and cool (about 18°C). If the person is afraid of waking up in the dark or is worried about finding the toilet, use a night light. Keep a window open when possible to let in fresh air and prevent the room from becoming stuffy. The bedroom should be uncluttered and the bed comfortable and supportive.
• Limit screen time: The blue light from electronic devices can affect the body clock and make it harder to fall asleep. Screen devices can also be overstimulating when the person needs to relax. The person with dementia should reduce screen time towards the end of the day.
• Engage in physical activities: Being active can produce a satisfying feeling of tiredness that makes sleep easier. Physical activities, such as walking and gardening, are particularly good for improving sleep quality. If possible, the person should engage in these activities for at least 20–30 minutes several times a week. However, too much activity in the evening can keep a person feeling awake.
• Avoid stimulants: Caffeine and other stimulants can reduce feelings of sleepiness and increase the need to use the toilet. It is best to switch to non-caffeinated drinks from lunchtime onwards. Similarly, nicotine increases heart rate and reduces feelings of sleepiness, so smoking should be avoided in the evening. While alcohol might make it easier to fall asleep initially, it leads to poorer sleep quality and increases the likelihood of waking up in the middle of the night.
• Eat a light meal several hours before sleep: This can prevent the person from feeling hungry at night or too full to fall asleep. If the person wakes up hungry, a glass of milk or yogurt may help. Avoid offering food at night, as this may cause them to wake up due to hunger.

How to spot common sleep problems in dementia patients

Sleep disturbances are common in people with dementia, with studies estimating that about 25% to 50% of adults with dementia experience sleep disturbances. The type and severity of sleep disturbances may vary depending on the type and stage of dementia. Here are some common sleep problems in people with dementia:

• Difficulty staying or falling asleep, which can be caused by changes in the brain, ageing, problems with the sleep cycle, side effects of medication, or other factors.
• Insomnia, which occurs in 25% to 33% of people with dementia.
• Sundown syndrome, which refers to increased confusion, agitation, anxiety, and aggression in people with dementia at night or in the early evening.
• Problems with movement during sleep, such as restless leg syndrome or rapid eye movement (REM) sleep behaviour disorder, which can cause people to act out their dreams.
• Sleep-related breathing disorders, such as sleep apnea, which is common in people with Alzheimer's disease.
• Excessive daytime sleepiness, which is more common in people with Parkinson's disease dementia or Lewy body dementia than in those with Alzheimer's disease.

If you are concerned about a loved one with dementia and potential sleep problems, it is important to talk to a doctor. They may have questions about sleep habits, medications, diet, and any other health conditions, which can help diagnose what is disrupting their sleep.

Frequently asked questions