Some individuals who are living with dementia can experience problems with their sleep. This has a significant effect on their own quality of life as well as difficulties for those caring for them. You may experience that they sleep during the day and are unable to sleep at night or countless waking during the night. You may also notice that they act disorientated or complain that they are tired.
There is a lot of information widely available on the internet about medication that can help people with dementia with sleep but most of it is followed by a disclaimer that they may not work well, and the side effects can be significant. So that makes us question, what non-drug alternatives are available? It is important to consider non-drug alternatives as they can be used in combination with medication and give options to those carers who think that sleep medication is proving to be ineffective or those who do not want to take the risk of giving it.
Non-drug methods can be difficult because they require a lifestyle change and should not be thought of as an immediate solution to the sleep disturbances experienced in people with dementia. In addition to this, these methods have not been widely tested on all sub-types of dementia and it is possible it can work with one but not another.
Something which is often mentioned when researching how to help a person with dementia sleep and wake up ‘normally’ is setting a routine, but what does this actually mean and what can help with this? Here are some tips:
- Setting an alarm and waking up the same time every day. It is helpful to make this earlier in the morning so that it can apply to all days of the week. For example, there is no point in trying to set a routine where they wake at 11 am but 2 days of the week they have an appointment at 9 am and have to wake earlier.
- You should encourage them to get out of bed when the alarm goes off and not snooze.
- All of this should apply to setting a bed time too.
- It is worth considering a body clock or daylight clock as it begins to light up 30 mins before your chosen wake up time (mimicking sunrise) and lights down 30 minutes before bedtime (mimicking sundown). This is a good purchase because after a few days you may no longer need the alarm and just the lighting would be sufficient to wake them up, it can help regulate the sleep/wake cycle in a gentler way (no more loud alarms). This is also great because it works effectively all year round because someone with dementia may be unaware of the time of day and may think that during the different seasons it can be too bright to go to sleep or too dark to get up. Here is one clock I think works well: https://www.johnlewis.com/lumie-bodyclock-starter-30-wake-up-to-daylight-sad-light/p151985 (but do not feel limited to this only).
Now the next thing I am going to mention deserves its own blog post but I will summarise it and tell you everything you need to know. Most people do not realise the impact of blue light exposure on sleeping in people without dementia so it seems like a sensible idea to apply it to people with dementia. There is a lot research available on the effect of blue light exposure on melatonin production and circadian rhythms and it has shown to have a significant effect on health, mood, cognitive function along with sleep.
Devices that emit blue light include television, tablet’s, iPad’s and mobile phones (to name a few). It has been mentioned that we should stop using these devices approximately two hours before bed and this will help them drift off to sleep however most of us know that it is not that easy. If your family member who is living with dementia likes to watch TV right up until their bed time it may be helpful to switch this to an iPad or tablet (or a gadget that allows you to adjust the brightness).
Turning the brightness down can reduce the amount of blue light exposure and some devices have a ‘night’ or ‘evening’ mode where the light is dimmer and warmer. On some of these gadgets, you can also set a timer so that it enters this mode automatically for example two hours before bed time. If your gadget does not have this then there are some apps available, but they require you to use their own browser which can prove difficult and confusing for someone with dementia as it is not what they are used too (not to mention poor reviews and added costs of these apps).
Two final suggestions that can limit the amount of blue light during the evening in your house but also do not require major changes to the household are smart lights and amber glasses. If your family member who has dementia enjoys reading at night, use warm coloured light bulbs in your lamp at night. You can also purchase smart lights, with this you can control all light bulbs and set automated timers from an app on your phone, an example is Phillips Hue.
To have a whole smart lighting system in your house can be expensive so another option is amber glasses. They require no changes to the household and it is especially beneficial for those family members with dementia who enjoy watching television close to bedtime. Someone who has dementia could benefit all round from wearing these glasses in the evening as it blocks blue lights from all the devices you already have! Amazon sell plenty and they do not have to be expensive. It may your family member with dementia some time to get used to these glasses and you may have to keep an eye on them so they do not take them off.
Finally, here are a few final tips to keep in mind when trying to minimise sleep disturbances in someone with dementia:
- Limit daytime napping.
- Try to switch drinks to caffeine free alternatives. If this is not possible, try to avoid these drinks from lunch time onwards- herbal teas are great!
- Try to avoid any alcohol or nicotine at night. A glass of wine with dinner may be part of a normal routine but it might be helpful to try without for one night to see the outcome.
- Try to limit the use of the bedroom for anything other than sleeping, changing or sex.