Understanding sleeping problems in dementia

Jun 17, 2020

Understanding sleeping problems in dementia

Understanding sleeping problems in dementia

Posted in : Living with dementia on by : Pooja Jain

It’s no surprise that getting a good night’s sleep is an essential part of staying healthy. Sleeping gives your body and mind the time to rest, repair and rebuild. It can help with:

  • Better concentration and attention span
  • Learning and memory
  • Keeping your heart and immune system strong
  • Keeping your cravings and weight in check
  • Looking after your mental health and emotional wellbeing

Most people sleep between 7 and 9 hours every day. With age, our sleep patterns change. Older adults can take longer to fall asleep and sometimes struggle to stay asleep throughout the night. They also spend more of the night in lighter stages of sleep, getting less deep sleep than younger adults. This is in part due to a lower amount of melatonin (a hormone that promotes sleep) in older adults. To learn more about how sleeping works, read The healing power of sleep

Changes in sleeping patterns with dementia 

A well-rested and good night’s sleep is also important for people with dementia and their quality of life. However, sleep problems tend to be much more frequent and severe for those with dementia. Someone with dementia can experience the following changes in sleep patterns:

  • Sleeping too much 
  • Struggling to fall asleep
  • Difficulty staying asleep
  • Less deep and restful sleep
  • Constantly waking up throughout the night
  • Night-time wandering and disorientation
  • Finding it hard to stay awake during the day and taking frequent naps
  • Feel lethargic and tired during the day

For someone with dementia nighttime can be lonely, and filled with strange sounds and shadows. They may struggle to tell the difference between reality and a nightmare. This can contribute to their sleeping difficulties.The occurrence and severity of sleep problems will vary across different types of dementia. 

Types of dementia and sleeping disturbances 

Alzheimer’s disease:

Someone with Alzheimer’s may start to experience slight sleep disturbances early on, taking more time to fall asleep, having lighter and more fragmented sleep and napping during the day. As the condition progresses, “Sundowning” might occur. Sundowning is marked by increased confusion, wandering and agitation that tends to happen later afternoon into early evening, which disrupts sleep. You can find out more about sundowning by reading our blog: Understanding sundowning in dementia. At the late stage, the severity of sleeping problems can increase with someone with dementia being awake for almost 40% of the night, while spending a significant part of their day asleep. 

Lewy body dementia: 

40% of people with Lewy body dementia have a light sleep disorder called rapid eye movement (REM) sleep behaviour disorder. This causes people to act out their dreams through physically moving their arms and legs or talking in their sleep. It is also more common for people with this diagnosis to be sleepy and take lots of naps during the day.

Parkinson’s disease: 

The sleep disturbances are often similar to those of Lewy Body dementia.  People with Parkinson’s will experience excessive daytime sleepiness, fragmented sleep at night and sleep disorders like REM sleep behaviour disorder and Restless legs syndrome. The symptoms of Parkinson’s, including muscle rigidity, tremors, and muscle stiffness, make falling asleep and staying asleep more difficult because they cause persistent movement, painful joints and muscle spasms. 

Impact of sleep deprivation

Persistent sleep disturbances can have some serious consequences that affect quality of life, including:

  • Faster disease progression 
  • Poorer balance & increased risk of fall  
  • Reduced participation in daily activities 
  • Lower attention span & slower reaction time
  • Worsened memory
  • Depression
  • Delirium 
  • Agitation and hostility
  • Onset of other chronic conditions

However, more importantly sleep disturbances affect YOU too. Sleep deprivation is a source of physical and psychological stress because if the person you are caring for is up, it’s likely that you are up too. To find out why these sleep disturbances occur, have a look at our next blog: Causes of sleep disturbance in dementia.


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