No matter what stage of dementia your loved one is in, you’ve likely noticed a shift in their sleeping habits. Are they sleeping a lot during the day? Do they wake often during the night? Disruptive sleep patterns are a common symptom of dementia, and these patterns tend to change as the disease progresses. But even though seeing a dementia patient sleeping a lot may be worrisome to a caregiver, it isn’t always a cause for concern.
Find out why people with dementia may experience excessive sleepiness, different sleep disturbances to watch for, and how to care for your loved one while managing ever-changing sleep schedules.
Do people with dementia sleep a lot more than they used to?
People with dementia tend to sleep frequently throughout the day and night, and time spent sleeping typically increases as dementia progresses. The National Institute on Aging recommends that seniors get seven to nine hours of sleep each night. However, research shows that dementia patients may sleep for anywhere from 13 to 15 hours in a 24-hour timeframe.
Although nearly half of older adults have experienced difficulty sleeping, sleep disorders affect up to 80% of dementia patients. Most often, significant changes in sleeping patterns are first seen in the middle stages of dementia.
The most common sleep disorders that affect dementia patients are:
- Excessive sleeping, also known as hypersomnolence
- Insomnia, which is the inability to fall or stay asleep
- Sleep-disordered breathing, most commonly diagnosed as sleep apnea
- Sundown syndrome, which causes sadness, agitation, fear, delusions, and hallucinations
- Physical disturbances, including ailments like restless leg syndrome
- Sleep pattern reversals, or sleeping all day while being awake all night
Medical professionals are still unsure about exactly why dementia affects sleep patterns, but these changes can affect your loved one’s lifestyle and routine.
Why do dementia patients sleep so much during the day?
If you notice someone with dementia is sleeping a lot during the daytime, they’re probably making up for their inability to sleep at night. They may nap on and off throughout the day to make up for lost sleep, snoozing for 10 minutes here or for an hour there.
People with dementia have a harder time than they used to with completing regular tasks, and they end up feeling exhausted from the mental stimulation of the day. Dementia patients will likely feel the need to sleep after completing even the smallest chore. Excessive sleepiness can lead to falling asleep during meals or becoming too tired to get up and use the restroom.
Other common dementia symptoms like wandering and time disorientation can also cause daytime sleepiness. Wandering often becomes more common as dementia progresses, and it can cause dementia patients to not only be awake but active throughout the night.
Time disorientation affects a person’s ability to distinguish between night and day. Dementia patients experiencing time disorientation may begin their day whenever they wake up, even if it’s midnight or 3 a.m.
What are the effects of sleep disruptions?
Even though it may seem like they’re constantly sleeping, dementia patients don’t typically get good quality sleep. And when any person, whether they have dementia or not, doesn’t get enough quality sleep, their physical and mental abilities may suffer. People with dementia tend to get less slow-wave sleep and rapid eye movement (REM) sleep, which are two types of deep sleep that enable people to wake up feeling refreshed and energized.
Disrupted sleep patterns in dementia patients can cause:
- Increased irritability throughout the day
- Decreased attention and focus
- Reduced cognitive performance
- Increased psychiatric symptoms
- Heightened risk of falls
Some medical professionals believe that long patterns of disruptive sleep can be a precursor to a dementia diagnosis. According to years of research, sleep disturbances have been linked to a higher risk of developing specific dementias like vascular dementia and Alzheimer’s disease.
How do different types of dementia affect sleep?
Sleep disturbances are widely reported in people with Parkinson’s disease and Lewy body dementia, affecting up to 90% of dementia patients with those diagnoses. Doctors and researchers also agree that there’s a strong link between vascular dementia and sleeping a lot, sleeping too little, and other strange sleep issues.
Vascular dementia and excessive sleeping
Vascular dementia is the result of reduced blood flow to the brain caused by brain damage, stroke, or genetic disease. People with vascular dementia are 2.5 times more likely to suffer from insomnia, but the cause of that insomnia may actually be easy to identify.
In many vascular dementia patients, obstructive sleep apnea (OSA) is the culprit of sleep disruptions. OSA occurs when a person’s upper airway either partially or completely closes during sleep, most often resulting in loud snoring or a fit of coughing right before a person wakes up. OSA is common in dementia patients, and it can have serious complications like heart attack and stroke.
Excessive daytime sleepiness may be a symptom of OSA and is a risk factor for vascular dementia. In a historic, 10-year study of more than 1,000 people, individuals with excessive daytime sleepiness were 4.44 times more likely to develop vascular dementia.
Sleep patterns in people with Lewy body dementia and Parkinson’s disease
People with Parkinson’s disease and Lewy body dementia disease often experience sleep pattern disruptions. Nearly 66% of patients with Parkinson’s disease report suffering from sleep disorders.
If your loved one has one of these diagnoses, it’s more likely they’ll sleep during the day and stay awake overnight. Common symptoms of these types of dementia include excessive daytime sleepiness, insomnia, hallucinations, restless leg syndrome, and OSA.
Some of these symptoms, including insomnia, restless leg syndrome, and OSA, can be treated with medications or therapies. Talk to your loved one’s doctor about potential treatments that may help improve sleeping patterns.
How can I help manage a loved one’s sleep patterns as dementia progresses?
Even though increased sleep is considered a normal side effect in dementia patients, trouble sleeping and excessive sleep have been tied to troublesome issues like depression, anxiety, and apathy.
If your parent is in memory care or an assisted living facility, check in with the staff to ask if they have any “sleep hygiene measures” in place. Almost 75% of nursing home residents suffer from sleep disorders, likely caused by ongoing activities and health care procedures taking place all hours of the day. Options like dimming lights at night, providing sound machines in bedrooms, and limiting caffeine or other stimulants in the evenings can help communities promote good sleeping routines.
When caring for a loved one at home, you can make environmental changes that might improve sleep.
- Create a daily routine. Help your loved one stay engaged and active during daylight hours. When their days are full of planned activities, a nighttime sleep schedule is easier to follow.
- Avoid caffeinated drinks and heavy meals. Plan dinnertime several hours before going to bed, and reduce caffeine intake later in the day.
- Establish a bedtime routine. Make sure your loved one is going to bed at the same time each night, and try to create a winding down ritual like undressing, showering, and then getting into bed.
- Avoid upsetting situations. Try not to bring up distressing topics or turn on disruptive television shows before bed.
- Consider keeping a “sleep diary.” Jot down notes each day to track key pieces of information on your loved one like what time they go to bed, what time they wake up, and how often they nap.
If you’re worried that your parent is sleeping too much and suspect something other than dementia may be to blame, contact their doctor as soon as you can. It’s possible that something else may be causing their extreme sleepiness, like a respiratory or cardiac issue or a negative response to a medication. Some causes of disruptive sleep patterns can be treated easily if they’re caught in time.
Support for caregivers
You know all too well that when your loved one isn’t sleeping well, neither are you. Many dementia caregivers experience sleep disruptions that can lead to health problems like anxiety and clinical depression. Caregivers prioritizing sleep are more likely to:
- Carve our time for self-care and favorite hobbies
- Return to an exercise and wellness routine
- Experience reduced feelings of stress and anxiety
Being the sole caregiver for a loved one can be rewarding and challenging all at the same time. In-home care is a great option to explore as your loved one’s dementia progresses. You can also connect with others who are going through similar experiences on our Caregiver Forum. This unique space offers caregivers a place to discover and share tips, give and receive advice, and find much-needed support.
Sources:
A Good Night’s Sleep (https://www.nia.nih.gov/health/good-nights-sleep)
Dementia and Sleep (https://ogg.osu.edu/media/documents/sage/Roth%20sleep%20week%207.pdf)
Sleep Disturbances in Dementia: What They Are and What To Do (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062259/)
Excessive Daytime Sleepiness in Major Dementia Syndromes (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709580/)
Parkinson’s Disease and Sleep (https://doi.org/10.1053/smrv.2002.0229)
Sleep Disturbances Increase the Risk of Dementia: A Systematic Review and Meta-Analysis (http://dx.doi.org/10.1016/j.smrv.2017.06.010)
The Relationship Between Obstructive Sleep Apnea and Alzheimer’s Disease: (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542637/)