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8 Ways to Help Someone With Dementia Get a Good Night’s Sleep

Try these methods that don’t use pharmaceuticals

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Dementia and sleep disruptions go together.

Up to 25 percent of people with mild or moderate dementia have difficulty sleeping, and the likelihood rises to 50 percent for those in the disease’s advanced stages, according to the Mayo Clinic. People with Lewy body dementia or Parkinson’s disease dementia are especially prone to sleep disorders.

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For caregivers, the lack of sleep makes a difficult job even harder with everyone operating on a shorter fuse. The easy fix that comes to mind — sleeping pills — is a last resort, to be given to dementia patients only after exhausting all other options and sparingly even then.

“Anything we’re going to give for sleep could contribute to cognitive impairment,” says Helen C. Kales, M.D., chair of the Department of Psychiatry and Behavioral Sciences at UC Davis Health. Sleeping pills exacerbate confusion, anxiety and depression in dementia patients, as well as common dementia behaviors, such as sundowning, agitation and even aggression.

Short of hiring a home health aide to take care of a loved one during the night, what can caregivers do to help someone with dementia sleep? Plenty, experts say, starting with this list.

1. Soak up the sun

Activity and daylight can help regulate sleep-wake cycles, which are thrown off-kilter in people with dementia.

“Older adults get only a fraction of the natural light they should be getting, but that light is really important for circadian rhythms,” Kales says. Morning light is best, but get outside whenever light is in abundance, even if it’s later in the day.

Research shows that 20 minutes a day of bright light reduces depression, a common problem with dementia patients that contributes to difficulty sleeping, says Monica Moreno, senior director of Care and Support at the Alzheimer’s Association. Even better, combine exposure to daylight with an activity, such as going for a walk. That way, “they’re exerting energy, and hopefully, it will make them more tired in the evening.”

2. Limit naps

Keeping the person engaged in activities helps discourage naps, which should be limited to one a day for less than an hour, Kales says. Caregivers may be inclined to let the person take longer naps to get a lot done during that time, but that’s a mistake because the person they’re caring for won’t sleep at night.


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3. Serve the right meal at the right time

Carbohydrates are a good source of energy during the day, but switch to proteins at night, says Ardeshir Hashmi, M.D., section chief of Cleveland Clinic’s Center for Geriatric Medicine. A protein-rich dinner makes people sleepy.

4. Cut off liquids after a certain hour

A glass of warm milk is the classic example of a protein that promotes sleep. But drinking any liquid right before bedtime could wake the person up in the middle of the night when nature calls.

At that point, “getting the person back to sleep is very difficult,” Hashmi says. Instead, he suggests encouraging hydration in the morning and afternoon and cutting off liquids in the evening.

Minimize caffeine, and read medication labels for potential side effects. Some antidepressants can cause sleeplessness, and some blood pressure pills lead to more frequent urination, experts say. Talk with a doctor about switching medication or giving it early in the day.

5. Create a pleasant sleeping environment

Establish cutoff times for electronic devices, too. The National Sleep Foundation recommends turning off phones, tablets and televisions at least an hour or two before bedtime. Keep the bedroom quiet and comfortably cool, dim the lights and draw the curtains.

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6. Have a consistent bedtime routine

Parents often develop a routine for putting their children to bed every night. Do the same for someone with dementia.

That routine starts with a consistent bedtime and certain prompts leading up to it, such as having the person change into their pajamas and use the toilet, Hashmi says. As part of that routine, he suggests committing to soothing activities just before bed, such as playing soft music, giving gentle back rubs and taking a warm shower or bath if the person wants one.

7. Add a dose of melatonin

Although sleeping pills are discouraged, natural substances such as melatonin promote sleep and are OK to use, Hashmi says. Melatonin comes in pill form and can be purchased without a prescription.

The key is finding the right dose because too much melatonin can make it harder to fall asleep.

“It’s a little hit or miss, but it works,” he says. Hashmi suggests starting out with a low dose of 1 or 2 milligrams. If the person wakes up in the middle of the night, you can give an additional dose to help them get back to sleep.

8. Seek help

Doctors prefer that you try nonpharmaceutical solutions first, but “if the caregiver has done all of these things, it’s OK to reach out to the doctor,” Moreno says. For one thing, the problem may have other causes.

“It might be one of 11 different types of sleep disorders, like snoring or gasping for air,” Hashmi says. Some situations demand extra help, especially if hard-to-break old habits are involved.

For example, “people who worked the night shift throughout their lives may get up, get dressed and try to walk out of the house,” Hashmi says. Because that’s a safety issue, caregivers may need to hire someone to cover for them overnight or alternate shifts with a relative to get some sleep.

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