After a long, busy day, many of us love snuggling under the covers and getting some much needed shut-eye. Unfortunately, a common symptom of Alzheimer’s is difficulty going to and staying asleep. Additionally, many people with Alzheimer’s exhibit increased agitation in the evening (usually after the sun sets and into nightfall). According to Alzheimers.org, as many as 20% of people with Alzheimer’s may experience greater confusion and restlessness during these “sundowning,” hours. What causes this phenomenon, and what can you do as a caretaker to help your loved one enjoy a more relaxing and restful night?
What Causes Sleep and Sundowning Difficulty for those with Alzheimer’s?
As with so many symptoms related to Alzheimer’s, the reasons behind sundowning trouble aren’t exactly clear. Is it directly caused by Alzheimer’s, or is it the result of another symptom? Researchers aren’t sure. Alzheimer’s fundamentally changes the brain, which could mess with a person’s normal sleep/wake clock, making it difficult to fall asleep and stay asleep at night.
Others have suggested that the shadows of the evening may increase confusion or that perhaps a person with Alzheimer’s has difficulty separating dreams from reality. Then again, maybe the person is merely tired or cranky after a long day just like the rest of us! Perhaps he or she is picking up on a caregiver’s frustrations and fatigue at the end of the day.
Many older adults may also suffer from sleep-related issues that have nothing to do with Alzheimer’s, like sleep apnea or restless leg syndrome. If they suffer from a urinary tract infection or incontinence, their aggravated behavior can be the result of physical discomfort that they may not be able to communicate effectively.
How to Get a Person with Alzheimer’s to Fall Asleep and Stay Asleep
To help your loved one enjoy a long and peaceful night’s sleep, you’ll need to try and understand what is causing their increased agitation so you can address it. Here are some suggestions to help increase the chances of your loved one (and you) getting some great shuteye:
- Approach your loved one with kindness and care no matter how exhausted you feel. Keep your voice warm and pleasant. Your loved one may be able to pick up on your frustration after a long day, which may cause them to reflect back those same feelings.
- Go to the doctor. Make sure your loved one is not suffering from any unknown physical issues that could be disrupting their sleep, like a urinary tract infection, a rash, restless leg syndrome, etc.
- Let there be light. Keep the lights on at night, including nightlights, so your loved one does not feel confused or frightened at home during the night.
- Add activities. Make sure your loved one is active throughout the day so that he or she will be ready for bed at the end of the day.
- Make the environment comfortable. Make sure your loved one has a comfortable sleeping area. That may mean turning the temperature up to keep them warm or playing a sound machine with soothing music to drown out traffic noises.
- Keep to a schedule. Maintaining a consistent sleep/wake schedule will add predictability to your loved one’s life and will help their internal sleep/wake clock stay consistent. Try to encourage your loved one to go to bed at roughly the same time each night and wake them up at the same time each morning. This even extends to keeping nap times and meal times consistent, too. The more consistent the schedule, the stronger the sense of routine will become.
Of course, even if you follow all of this advice, your loved one may still have trouble during the sundowning hours. In this case, just try to be understanding and patient. Alzheimer’s is a very mysterious disease, and sometimes the only thing you can do is continue to support your loved one through the good times and during the rough patches.
If you are struggling with getting your family member with Alzheimer’s to go to sleep, consider going to a support group to get advice from other families dealing with the same issue. If you live in Poway, 4S Ranch, or in San Diego County, we invite you to attend Sunshine Care’s free monthly support meeting for family members of people with Alzheimer’s. This support group is open to the public! Find out when our next meeting is scheduled.
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