Sleep and dementia
Sleep matters at every stage of life. When I was doing exams at school, my mum always used to tell me to stop studying the day before and have a good night’s sleep. She wasn’t academic, but she knew that your memory is always worse after a bad night. People with dementia have memory problems, and this is probably made worse from not having a decent sleep.
It is not only the person with dementia who suffers from insomnia. If they are awake, everyone is awake. If they live in the same house, they can cause chaos by turning night into day, waking the other person up, switching on lights, getting dressed and getting organised to leave the house in unsuitable clothes at unsuitable times. If they live somewhere else, you may be called in the night because the neighbours have found them in the street, or the police have found them walking about in the dark. Or it could be the out of hours phone calls asking you the time.
If you’re looking for advice on how to deal with this problem, you will find some on this website and in my books on caring and dementia.
Here are three different areas to approach.
Exercise and Activity
The first one is to consider whether having more exercise and activity throughout the day will make the person more tired and therefore more likely to have a good night’s sleep from natural fatigue. Exercise in the early part of the day seems to work better, especially if it is out of doors and in daylight. But that is not always easy to achieve.
Bedroom design
The second area is in the design of the bedroom. It’s known that people will sleep better in a warm bed in a cool room. My memories of childhood in a largely unheated house make me remember how reluctant I was to get out of bed when the floor was cold under my feet. There is also important work that can be done with reducing extraneous sources of noise and light after dark. Movement sensor light is good because it means that the room can be very dark, but lights will come on to improve safety if the person gets up during the night for example to go to the toilet. There is more detail in the book called Carers and Caring.
Bedtime routine
The final area to consider is the routine running up to bedtime. Making things quieter and having a plan that perhaps involves a warm drink and a slowing down can help. You could ask the doctor whether it’s acceptable for the person to have an alcoholic nightcap. You have to be very careful with this with respect to medication that might interact, and of course if the person has alcohol related brain damage it would be out of the question.
There have been successful policies in care homes where the night staff wear dressing gowns and night clothes instead of uniforms so that if a resident wakes up and comes out of the room, they have some cues that it is the middle of the night, and they should go back to bed. We are sometimes not aware of noises in our own houses that might make the person get up to explore. One example of light that can distract is having a movement sensor light in the garden, which could wake the person up and then tempt them to go out and investigate.
As a carer, a good sleep is vital for your own health, and if that can’t be achieved it is worth checking if someone else can do an overnight “sitting” for you, so you can get a way to a friend or even a hotel to get an uninterrupted night. The local carers organisation will be able to let you know about eligibility for respite care in your local area.
There is more in my book Dementia which is now available as an audio book as well as Kindle and paperback.
