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Jul 27, 2023

My Mom (Who Has Dementia) Won't Sleep. What Do I Do?

Written By: Home Instead Surprise, AZ
How To Keep Your Loved One With Dementia Active

Sleep is an essential part of our overall well-being. From increased healing to overall mood improvement, a good night’s rest ensures we’re able to take on each day with our best foot forward. When caregiving, sleep (or a lack thereof) can be a stressful aspect of your loved one’s routine to nail down.

Here at Home Instead, we understand how dementia creates a unique set of challenges when it comes to your loved one’s needed rest. Sleep disturbances, such as sundowning, are a common experience, yet can make the evenings more difficult than they have to be. We’ve had the privilege of assisting many families in navigating all things related to sleep and empathize deeply.

Although each one of your loved ones is unique, we hope sharing common strategies for success can provide some much needed rest for the entire family.

How does dementia affect my loved one’s sleep schedule?

Before we dive into sleep routine management techniques, it's crucial to understand how dementia affects sleep patterns. As dementia progresses, you may notice your loved one’s sleep routine start to shift. There are many possible reasons for this from their medications, unresolved pain, other illnesses they may have including angina or diabetes, depression, poor sleep environment, sleeping during the day, all the way to inactivity and boredom during the day. There are also brain changes as part of the progression of the disease such as melatonin, a hormone in the brain, not being produced at a steady rate as the sun goes down. For the majority of us, melatonin starts to indicate to your body it’s time to wind down for the evening. For those with dementia this may not be happening in the right amount or at the right time. Sleep is a delicate balance for all of us, and adding dementia in the mix makes it much more difficult.

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I’ve heard of sundowning before… what is it exactly?

Have you noticed the mid afternoon or early evenings have become increasingly difficult for your loved one with dementia? They may be experiencing a condition called sundowning. Late day confusion may be caused by a variety of factors. Understand that your loved one with dementia processes information slower than the majority of us. As the day wears on their brains have been working hard all day just to get through a normal series of steps in daily living. This may make them really tired, rundown and agitated by the end of the day.

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Sundowning is a stage in mid to late dementia development that your loved one can experience:

  • Increased confusion
  • Anxiety or stress
  • Difficulty sleeping
  • Disorientation
  • Pacing or wandering

As your loved one’s most devoted caregiver, we understand that this stage in battling dementia can feel increasingly difficult. We want to encourage you to understand your family is not alone. Although our list of tips have been effective with many clients, people are unique, so their care plans need to be the same. If the following list does not do the trick, please don’t hesitate to reach out to Home Instead for additional assistance.

The old sleep routine is no longer working, it’s okay to create a new one.

We understand how difficult it is to create one sleep routine, let alone begin again. That being said, the sooner you can accept this change, the easier it is to establish new patterns. By beginning a new sleep routine, both you and your loved one get to shake off any pressure that the old routine could have been bringing with it, increasing overall relaxation in your home.

To begin the task of establishing a fresh schedule, start by focusing on one aspect of consistency at a time. We recommend starting strict wake-up and wind-down times, even if your loved one is resistant at first. Although it’s easier said than done, after a few weeks, a habit will begin to form for both parties.

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During this shift, try incorporating calming activities before bed, such as reading, listening to soft music, or engaging in gentle stretching exercises. If the mornings are particularly difficult, try to create a bit of excitement. Fun breakfasts, daily activities, and outings give anyone an extra pep in their step, your loved one included.

I’m working on a new routine, but the evenings make my loved one anxious.

Anxiety and agitation often accompany sundowning, making it even more challenging to achieve restful nights. To help alleviate these symptoms, create a calm and soothing environment.

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Dim the lights in the evening and minimize noise. Engage in activities that promote relaxation, such as guided meditation or breathing exercises. Although not everything will be an easy fix, as a caregiver your participation is crucial in setting the soothing tone. Experiment with different techniques until you find what works best for your loved one.

I don’t have trouble getting my loved one settled for bed, but they wake up in the middle of the night and start “getting ready for work”

This is another common point of discussion among caregivers for a person living with dementia. They wake up at 2 or 3 in the morning and are ready to start their day. They may get up and start getting ready to go to work, convinced that they need to get going so they won’t be late. This can be disorienting and frustrating to a care partner who is also trying to sleep. When this happens don’t argue! Don’t remind them that they haven’t been to that job for the last 15 years. Try telling them that they have the day off, or that their boss called and wants everyone to have a late start today. Always try to go with their reality and agree with them first, then come back around to getting back into bed.

How can I keep my loved one active during the day so they are ready to sleep and stay asleep at night?

We all know the good night’s sleep that follows after a day of activity. Although it may look slightly different, keeping your loved one moving allows for a much easier evening routine to occur.

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Not sure what activity with dementia can look like? Here are a few of our Care Pro’s favorite activities:

  • Walking
  • Light yoga
  • Folding laundry
  • Sorting pictures
  • Dancing
  • Playing board games

The options are limited to you and your loved ones creativity! We find a lot of the greatest memories are formed by finding new activities to share together. Most importantly, it provides a sense of purpose that simulates the mind and body during the proper hours of the day.

Your loved one’s sleep routine won’t be fixed overnight… and that’s perfectly normal!

Caring for a loved one experiencing sundowning or irregular sleep patterns can be emotionally and physically draining. However, by understanding a new routine needs to be put in place and remaining patient, you can create an environment conducive to peaceful nights.

Remember, your loved one's needs are unique, so remain adaptable in finding the techniques that work best. As always, Home Instead is here to help make this process as easy as possible. If you need additional support of any kind, please don’t hesitate to reach out for help from a trusted Care Pro.

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