Restless nights: Dementia and sleep

By Pamela Stoikopoulos

Those with dementia sometimes find it difficult to sleep well at night for different reasons. This can be challenging for everyone involved as it can affect your precious sleep too! Below are some of the common problems family caregivers face and some ideas to help you overcome them.

Problems with sleeping

Some of these things could be getting in the way of your loved one sleeping well at night. He or she may:

  • Frequently wake up throughout the night.
  • Not be able to sleep at bedtime.
  • Get very upset just before bedtime.
  • Wake up in the middle of the night and think it’s time to get dressed.
  • Fall out of bed.
  • See imaginary people and may talk to them.
  • Think they are someone else.
  • Believe this is not their bed.
  • Wander around the house at night.
  • Try to get out of the house at night.

Sleep disturbers

There are many reasons why your loved one is having problems sleeping and it may take some detective work to determine the cause. Sleeplessness could simply be a symptom of the disease or it could be because he/she:

      • Isn’t physically active enough during the day to be tired at night.
      • Fears being left alone or is worried something bad is going to happen to them.
      • Feels hungry, thirsty, too hot or too cold.
      • Is in physical pain but cannot express it.
      • Doesn’t know if it’s day or night.
      • Needs to use the bathroom and/or can’t find the bathroom.

Night Time Tips

There are a number of steps you can take to encourage your loved one to sleep easier and better at night.

Daily routine:

  • Create a regular routine before bedtime. For example: Watch the news and then feed the cat. Then change into pyjamas and wash face, hands and brush teeth.Take bedtime pills and get into bed. Be sure to keep the schedule the same every night.
  • Don’t give big drinks near bedtime.
  • Discourage your loved one from napping during the day.
  • Try to encourage some exercise every day.

In the room:

  • Keep the room warm on cold days and cool on hot days.
  • Remove daytime clothes so they can’t see them.
  • Put a clock where your loved one can see it.
  • Cover the mirror if seeing a face in it is upsetting.
  • Darken the room but avoid shadows.

Home safety:

  • Have a night light in the washroom.
  • Keep walkways clear so your loved one doesn’t trip.
  • Put padding on furniture with sharp corners.
  • Hang a bell on the door so you can hear if they leave.
  • Use a baby alarm with the microphone in their room and the receiver in your room so you can hear them if they get up.
  • Lock doors of rooms you don’t want them to go into.

How to prevent falls out of bed:

  • Put the bed against a wall.
  • Use a lower bed.
  • Put a soft mat with non-slip backing beside the bed.
  • Use a double bed rather than a single bed.
  • Remove the bed frame and place the mattress on the floor.

How you can help:

  • Keep calm even if you feel upset, a strong reaction will make the situation worse.
  • Reassure your loved one that they’re okay.
  • Distract your loved with something pleasant like calming music.
  • Try to understand that they may be afraid.
  • Try different things like quiet music or singing to them.
  • Don’t raise your voice. Talk calmly and slowly.

Seek support

An occupational therapist can provide you with tools and tips to help you make your home safer and find solutions to improve sleep patterns. Remember also to seek support from your loved one’s doctor to help improve sleep quality and quantity.

While sleeplessness can be frustrating for you as a caregiver remember that your loved one is not intentionally trying to be difficult. Take deep breaths to help stay calm and talk in a slow, gentle voice to reduce anxiety and fear and to reassure your loved one that he/she is okay. Your soothing and reassuring response can go a long way in ensuring a better night’s sleep for everyone.

Pamela Stoikopoulos is a manager, communication at VHA Home Healthcare.