Simple strategies like maintaining a regular schedule and cutting caffeine can help ease sleep and behavioral problems that plague people with Alzheimer’s disease and dementia.
As many as 1 in 5 people with Alzheimer’s experience a disrupted sleep cycle or become increasingly confused, anxious or agitated late in the day and in the evening. These problem behaviors are called “sundowning,” which can be exhausting for both the person with Alzheimer’s and his or her caregiver.
Scientists don’t know why “sundowning” and sleep disruptions happen. They have several theories, including physical and mental exhaustion at the end of the day; an upset in the body’s internal clock; reduced lighting and confusing shadow images that cause the person with Alzheimer’s to become anxious and confused; sensing caregivers’ nonverbal signals of frustration and fatigue at the end of the day; disorientation because they can’t tell reality from dreams or simply less need for sleep, which is common in older adults.
Medications can help with some sleep issues, including restless legs syndrome or sleep apnea. But if Alzheimer’s is the primary culprit for sleeplessness or sundowning, most experts recommend trying other strategies and using medication as a last resort.
These suggestions are from the Alzheimer’s Association:
- Keep the home well-lit at night to cut down on the shadows that might be scaring your loved one.
- Keep the person’s bedroom comfortable and safe. Check the room temperature to make sure it’s not too hot or too cold; place nightlights in and around the room; and place motion sensors in case the person with Alzheimer’s tries to wander away in the night.
- Stick to a schedule. Whenever possible, get up, have meals and go to bed at the same time every day.
- Avoid stimulants like caffeine and nicotine (especially in the evening) and eat lighter foods at night.
- Plan more active days to help ensure the person with Alzheimer’s is tired at bedtime.
- Try to identify triggers – loud music, dogs barking, etc. – that might frighten the person.
- Watch your own moods; if you’re tired or frustrated, your stress will stress them out in turn.
