Not being able to rest properly can be draining - not only for someone with dementia - but for the person or people caring for them too.
If someone is having difficulty sleeping or resting, this can be due to several reasons. It could be symptoms of dementia, another illness, or the same aches or pains that everyone experiences from time to time.
When someone has dementia they may find it more difficult to express when they’re feeling uncomfortable or in pain. It’s important to try and find out why restlessness is occurring, and if there could be a solution. There may also be ways that discomfort can be relieved or managed to help someone feel better.
Why can someone with dementia have discomfort whilst resting?
All different types of dementia can affect resting and sleeping. But there are certain types that can mean sleep disturbance is more common such as Parkinson’s disease dementia or Lewy body dementia. This can include nightmares, and/or restless leg syndrome or involuntary limb movements.
There are different types of dementia and in some cases, people may have a combination of types. Dementia is experienced uniquely for everyone, regardless of the diagnosis. Symptoms may be similar, but not everyone will react in exactly the same way.
As we age we also become less flexible, our muscles become weaker and our bones more brittle. This can make everyday aches and pains more common, even if there’s been no strenuous activity. As people living with dementia tend to be older, aches and pains can be common.
Age can also affect our sleep patterns. Our sleep quality can deteriorate as we age, including in those who don’t have dementia. More time may be spent in bed but it’s often experiencing less quality sleep.
Sleep can be affected by other health issues like infections, dehydration and/or constipation. This may make extra bathroom trips necessary in the night, disturbing sleep.
It’s also possible that there may have been an injury from an accident like a fall that has since been forgotten about. Someone with dementia may be more likely to hurt themselves accidentally but either not realise, or not tell anyone.
If you think injury or other health problems could be the case, it’s important to check with a GP to look into any underlying causes. If there is something else at play, treating it may help someone rest better.
Problems sleeping can be common for people with dementia. The reasons for this can vary, but could include things like:
- Disrupted sleep patterns, being awake and restless at night but sleeping in the day
- Becoming disoriented at night when it’s dark if they wake up, possibly to use the toilet
- Being disoriented in time, thinking it’s daytime or time to go to work
- Not understanding or being able to tell the time between night and day
It’s hard to know exactly why dementia has an effect on sleeping patterns, and doctors can’t say for sure. It’s thought that the internal ‘body clock’ or sense of when it’s night and day becomes damaged - so people stop feeling sleepy when they normally would, or vice versa.
Sometimes, sleeping patterns are reversed so someone with dementia might stay up all night but sleep all day.
How do I know if someone is having trouble sleeping or resting?
Is the person you’re caring for having trouble sleeping? Here are some things you can do to find out why.
Look for changes in behaviour - Are they waking up more often, sleeping less and getting out of bed more? Is there any disorientation or confusion and does this often become worse at night?
Ask - If you don’t know the person you’re caring for, it can be helpful to try and find out their usual sleep pattern. Can you ask a relative or friend? Or can you ask the person what time they usually like going to bed and waking up. You could also ask how the person is feeling when they go to bed at night. Making sure someone feels secure and safe will help them to relax and sleep.
Establish a cause - When someone gets up in the night, try to find out the reason. Ask, if you can and provide reassurance.
Start a sleep diary - If you’re not sure how much sleeping is affected, try keeping a sleep diary. Monitor when the person is sleeping during the day, and what times they get up at night. This can help you figure out if the amount of sleep is enough.
What can you do to help someone rest and sleep better?
- Reassure. If someone gets up in the middle of the night, try to establish any cause for waking and think about sitting with them for a short time in a quiet environment with low lighting before guiding them back to bed. They may need to go to the toilet or be unsure about where they are.
- Activities. If the person is sleeping for long periods during the day, can you think of some activities to keep the person occupied? Gentle exercise like going for walks, or just getting outside and stimulation in the morning can really help to establish regular sleep patterns. Social activities, gardening and mild exercise are all great ways to keep occupied during the day.
- Medication at the right time of day. Certain medications can affect sleep patterns, sometimes making people drowsy. As people with dementia may have to take several medications, check with a doctor for the best time to administer it so it doesn’t interfere with healthy sleep patterns.
- Establish a routine in the morning and evening. Creating a routine for the morning and evening time can help to prep the body and mind for waking or for bed. Performing the same activities each night before bed and in the morning can also be reassuring. If you can change the morning and evening routine to distinguish them, this can work even better.
- Night lights for waking in the night. Sometimes when people wake in the night, turning on a large bright light can be jarring - or they may even have difficulty finding the light switch. Soft night lights that give off a gentle glow make it possible to get out of bed and to the bathroom safely, without disorientating bright lights.