Alzheimer's and Sleep: How Alzheimer's Can Alter the Sleep Cycle
Alzheimer’s disease can grow gradually, and for many people, major trouble only comes in the late stages. However, lots of lifestyle and personality changes can pop up earlier in the disease, and these can cause a considerable amount of worry, uncertainty and challenges in the daily routine. In this article, we will look into Alzheimer's and sleep problems. We'll look at what causes it and how to cope with it.
Sleep trouble is extremely common with Alzheimer’s disease, but the amount and severity of sleep disruption can differ quite a bit. While insomnia and restlessness is expected, some phases can bring the very opposite. Learn why sleep can increase with Alzheimer’s disease, what it means and how to handle the change.
Common Changes in Sleep Patterns
It’s difficult to predict exactly how Alzheimer’s disease will affect every patient, but there are a few patterns to watch for in relation to sleep. In fact, changes in the sleep/wake cycle can be among the earliest warning signs that something is not right.
Many Alzheimer’s patients experience:
- Trouble staying asleep. Trouble falling asleep, waking up often and dozing in and out of sleep are common.
- Sundowning. Restlessness in the late afternoon and evening hours. The setting sun can cause agitation, and some people will become irritated as they pace nervously and resist sleep.
- Sleeping for long stretches. You might notice your loved one begins to nod off more during the day, and is ready to hit the hay long before their usual bedtime. Sleeping for 10 to 12 hours at a time is not unheard of.
In general, the types of sleep disruptions change as Alzheimer’s progresses. The early stages usually bring more sleep: longer stretches of shuteye, more naps, or nearly constant drowsiness. In later stages, many people will want to sleep during the day and stay awake through the night.
Why the Duration and Frequency of Sleep Can Increase
Experts are still not certain how and why sleep disorders develop during the course of Alzheimer’s, but it is natural to assume the physical changes taking place in the brain will interrupt normal patterns of consciousness.
In fact, there are a few reasons why an Alzheimer’s patient may begin to sleep more.
Alzheimer's Impacts the Sleep Center of the Brain
As Alzheimer’s progresses, brain cells are lost and neurological connections falter in several areas of the brain. When the disease spreads to the middle — where the control center for sleep is located — waking and sleeping patterns can become irregular and unpredictable.
Medications Can Have Sleepy Side Effects
Alzheimer’s cannot be cured with medication, but the right drugs can help slow down the disease. However, many medications are known to interfere with sleep — some of them will keep you up, while others can make you very drowsy.
Thinking is Exhausting
You might not realize it, but thinking and conversing is actually quite taxing for your brain. For those with dementia, when the network of brain cells is beginning to degrade, calling on executive regions to work harder is not so straightforward.
They will have to put forth extra effort to communicate well. Although thinking might not drain the brain’s energy in the same way that physical exercise fatigues the muscles, there is plenty of evidence to show that too much brainwork makes you weary.
Go With the Flow or Stick to a Sleep Schedule?
Most experts recommend Alzheimer’s patients keep a very regular schedule: wake up, eat and go to bed at the same time each day. The more regular your 24-hour schedule, the easier it is to measure food intake and sleep, plus the more familiar (and less confusing) it will be for anyone with memory loss or comprehension problems.
On the other hand, a well-timed nap can do wonders for mood and energy, and there may be times when it is better to allow your loved one to doze off for a bit than fight with them to stay awake. If you do allow for a nap, be sure to limit it to 30 minutes — this way, it will not disrupt the sleep cycle too much and keep them wide awake in the middle of the night.
Natural and Medical Treatments for Sleep Issues
There are all sorts of drugs to promote or regulate sleep, but doctors warn that they might be more troublesome than they are worth when Alzheimer’s is involved.
Those who do use sleeping aids are more prone to falls, fractures, confusion and a decline in independence. Taking these meds for too long can lead to very serious health and lifestyle changes.
Non-drug therapies should be your first course of action when you are trying to establish a regular, healthy sleep cycle. There are some easy ways to naturally tweak sleep patterns that you may want to try out:
Use the Sun to Your Advantage
As soon as they wake up, move your loved one into the natural light, whether next to the window or out into the warm sunshine. This will trigger their internal clock, spark their energy and keep their circadian rhythm in check.
Likewise, gradually dim the light in the evening as night approaches, cutting out screen time altogether two or three hours before bed.
Keep Portions Small and Frequent
If you suspect heavy meals might be interfering with energy levels, try to keep them small, light and evenly spaced.
It’s better for Alzheimer’s patients to eat regular, manageable portions rather than tackle big meals, especially since appetite changes are often a big challenge as the disease progresses. Lighter meals can lift up spirits rather than weigh down stomachs.
Check With Their Doctor
In many cases, co-existing disorders can amplify Alzheimer’s complications. When someone seems to be sleeping much more than normal, depression could be at play.
In other cases, sleep apnea could be interfering with nighttime sleep; even if they make it through the night relatively peacefully, your loved one may not be getting the restful and rejuvenating sleep they need to stay energized during the days.
Ultimately, sleeping for longer stretches may just be a phase in the disease, and there is little that could (or should) be done to change it. If your doctor has ruled out other potentially harmful conditions or interactions that could be causing problems, it may be best to allow your loved one to get as much sleep as they need or want.
If they begin to wake up groggy and disoriented, be patient and take the time to ease them into their wakeful hours as best you can. Alzheimer’s care is no easy feat, but when you can find ways to go with the flow and meet in the middle, you can minimize the workload for everyone.