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Why Alzheimer’s Patients Sleep So Much

Has your loved one been sleeping more since being diagnosed with Alzheimer’s? Know why Alzheimer’s patients sleep so much, the causes and how to help them cope.

Why Alzheimer’s Patients Sleep So Much

If you have come across an Alzheimer’s patient whether it is a loved one or a friend you may notice that they tend to sleep a lot. Here we will discuss why Alzheimer’s patients sleep so much and how to help them.

People suffering from Alzheimer’s usually sleep a lot during the day and then find it very difficult to fall asleep at night. They tend to wander the house at night while people are asleep.

Most dementia diseases including Alzheimer’s tend to have a negative impact on the patient’s sleep/wake patterns. The longer the patient has suffered from the disease the sleepier they will be during the day. This will cause the patient to experience disrupted sleep at night which is not healthy for them.

Most patients with Alzheimer’s will experience a condition normally referred to as sundowning. It is a state where the patient gets agitated and exhibits behavior such as yelling, getting violent or pacing. This usually occurs when the sun goes down.

Most Alzheimer’s patients get institutionalized because of exhibiting incontinence and night wondering behavior. This is not necessarily because the family does not care but it’s because they find it difficult to care for someone who is unpredictable with their actions.

There are some patients who will experience sundowning throughout the day. The condition usually gets worse between 12:30 pm and 1:00 pm. In this case, a family member is able to handle such a patient as the wondering occurs during the day when everyone is awake and they are aware of what is going on.

Factors contributing to Alzheimer’s patients sleeping too much

The following are some of the factors that can lead to a patient suffering from Alzheimer’s disease to sleep so much:

1. Common sleep changes 

Many patients with this disease will experience changes in their sleep patterns, this according to the Alzheimer’s Association. It has not yet been proven why this occurs but it is suspected to occur from the impact of the Alzheimer’s on the brain.

Most sleep changes will occur in later stages of the disease but in some cases, they have been found to occur in the early stages of the disease. The common sleep changes experienced include:

  • Difficulty sleeping

It is common for Alzheimer’s patients to wake up often and find difficulty in falling back asleep during the night. Studies done on brain waves of such patients have shown a decrease in both non-dreaming and dreaming stages of sleep.

It is common for those who cannot sleep to wonder the house or call out thus disrupting the sleep of their caregivers.

  • Daytime napping and shifts in sleep/wake patterns

In this case, the patient tends to feel very drowsy during the day and then they cannot sleep through the night. Individuals tend to become very agitated during late afternoon or early evenings which is normally referred to as sundowning.

Most patients will spend at least 40% of the nighttime in bed awake and most of their day asleep and in extreme cases, the person may stay asleep all day and stay awake all night.

Because of this shift in sleep times, and the fact that they will spend a lot of time on the bed, ensure that they have a good and long lasting mattress and pillow on the bed.

1. Contributing medical factors 

The changes in sleep patterns in Alzheimer’s patients can be caused by other underlying medical conditions. Examples of such conditions include:

  • Depression 

Depression can sometimes cause patients to stay in bed for longer especially during the day. It also causes the individual to lose sleep especially at night which can cause him/her to feel tired and drowsy during the day.

  • Restless leg syndrome

The tingling sensation brought about by this condition will make the patient want to move the legs thus cause them to wonder.

  • Sleep apnea

This usually causes an abnormal breathing pattern when the patient is asleep. The patient tends to stop breathing many times during the night thus resulting in very poor sleep quality.

When dealing with Alzheimer’s only related sleep changes there are both drug and non-drug treatments that the patient can be placed on to help them deal with this issue. The non-drug approach is highly encouraged because different studies have shown that sleep medication does not improve sleep quality in adults in general.

Non-drug treatments for sleep changes in Alzheimer’s patients

Non-drug treatments for sleep changes in Alzheimer’s patients

These types of treatments are aimed at improving the sleep environment and sleep routine. You should always try non-drug coping methods first before decided to place the patient on sleep medication.

The following will help you create a conducive sleep environment and also promote rest for a person with Alzheimer’s:

  • Make and maintain a regular schedule for meals, going to bed and waking up.
  • Encourage the patient to have a regular exercise which should be done at least 4 hours before bed and never any later.
  • Ensure that you treat any pain the patient might have so as to ensure that they sleep peacefully throughout the night.
  • As the caregiver, make sure you take the patient out during the morning so as to receive morning sunlight exposure.
  • Ensure the patient avoids taking any alcohol, nicotine or caffeine.
  • In the event that the patient is taking a cholinesterase inhibitor, you should avoid giving him/her the medication right before bed.
  • Ensure that the patient’s room has nightlights as well as other security objects.
  • As the caregiver, you should make sure that the patient’s room temperature is comfortable enough to ensure that they get quality sleep during the night.
  • Discourage the patient from watching television when they are experiencing periods of wakefulness.
  • When the patient wakes up during the night, encourage him/her to stay in bed where they are likely to fall back to sleep.

Drug treatment for sleep changes in Alzheimer’s patients

There are cases in which non-drug treatments for sleep pattern changes can fail to work and thus you are forced to seek medical intervention. If your patient requires medication, it is recommended that the treatment begins with low dosages and go slow.

The risks that may occur in older patients who have cognitive impairment are many. They include confusion, increased risk of falling and fractures and a decline in their ability to take care of themselves.

It is important that the medication is discontinued for such patients once a regular sleep pattern has been established.

The meds that are prescribed are usually determined by the behaviors that accompany the sleep pattern changes. Using antipsychotic drugs should be considered with extreme caution as they can lead to stroke or even death.

Conclusion

It is clear to understand that changes in sleep patterns are not healthy for both Alzheimer’s patients and healthy people. It is the job of the caregiver to help the patient to establish a healthier sleep pattern by either using non-drug methods or sleeping medication.

It is not always the right choice to have an Alzheimer’s patient committed just because they have issues with sleep because from the information we have provided it is clear to see that this condition can be changed.

I hope we were able to answer the question of why Alzheimer’s patients sleep so much.

Sleep Restriction Therapy

Insomnia is the leading sleep disorder among Americans. Sleep restriction disorder is a behavioral therapy to deal with insomnia. Learn how SRT can help you to beat insomnia and to sleep better.

Sleep Restriction Therapy

This is one of the foremost treatments that are being used in the management of insomnia. Sleep restriction therapy is aimed at limiting the time that an individual spends in bed to just the time the individual spends sleeping. It is also aimed at increasing sleep efficiency by prolonging your sleeping time.

When you restrict the time you spend in bed it will create mild sleep deprivation that can create an earlier onset of sleep. The sleep that you will experience will be more effective and even deeper. You will also experience less night-by-night variation in the quality and quantity of sleep.

This therapy does not use any drugs and it has proven to be very effective in dealing with different types of insomnia. It will require a lot of dedication from the patient because it will prove very easy for him/her to fall off the treatment wagon.

The typical sleep restriction protocol

  • The first step that is taken when starting this therapy is determining the patient’s average total sleep time (ATST) per night. This can be calculated from a sleep diary that has been kept for a week thus representing the individual’s daily routine.
  • The next thing is restricting the patient’s time spent in bed to the ATST by establishing a fixed bedtime based on the preferred waking time in the morning. It is important that no sleep is allowed outside of the allocated sleep time and ensure that the sleep time is not less than 4 and ½ hours.
  • The next step is monitoring the efficiency of sleep on a daily basis which is calculated by multiplying the total sleep time (TST) by 100.
  • Once you find that the weekly average sleep efficiency exceeds 90%, you should increase the time spent in bed b 15 minutes. If the average weekly sleep efficiency falls below 80% you should decrease the time spent in bed by 15 minutes.

The main idea behind sleep restriction therapy

main idea behind sleep restriction therapy

This type of therapy aims at ensuring that the patient sleeps the entire time he/she is in bed. The patient will be required to set a strict sleeping and waking time that he/she has to follow.

With at least 30% of Americans found to be suffering from chronic insomnia by a National Sleep Foundation study, sleep restriction therapy is a welcome remedy.

The time allocated for sleep will be determined by estimating how long the patient has actually been sleeping during the night and not the time he/she has been spending in bed.

For example, a patient might spend approximately 7 hours in bed but only sleeps for 5 hours. The Sleep restriction therapy (SRT) will be restricted to 5 hours and the patient will only be allowed to spend this amount of time in bed no more, no less.

The time allocated for bed can be slowly increased if the patient still feels sleepy during the day. The increase is usually done by adding 15 minutes at a time.

Side effects of SRT

All treatments usually have side effects even this one despite the fact that it does not use meds.

The side effects exhibited by patients who underwent this trial in Scotland include the following:

  • A constant headache
  • Excessive sleepiness during the daytime
  • A lot of fatigue

The SRT treatment in a way may be soliciting these side effects on purpose when you consider that the people who are having their sleeping time reduced are those suffering from insomnia. With time these side effects will disappear and thus render the treatment successful.

Who should conduct this therapy?

A normal physician is not allowed to conduct this treatment as they have not been properly trained. You should see a psychologist or psychiatrist to help you through this therapy though you can still do it all on your own if you are a person who has a strong will.

When SRT is conducted effectively it will only take a few weeks to retrain an insomnia patient to have a regular sleeping schedule.

SRT in the treatment of depression

When someone is suffering from insomnia it can mean that he/she is suffering from depression as well.

You may find people who suffer from both depression and insomnia will usually fall asleep at the right time but they will probably wake up during the night and find it hard to go back to sleep.

SRT has proven to work as a short-term treatment for depression. When you do not allow people to sleep for the time they want it can help to reduce depression though it does not work for everyone.

Conclusion

SRT has been used for a long time now and it has been effective in helping very many people suffering from insomnia.

Most people would run to getting drugs to help them fall asleep at night but this therapy is a great alternative that does not use any chemicals. It is a type of behavioral therapy that will be sure to work long-term as long as the person remains focused for a few weeks.

Since this therapy will require you to spend time in bed, it is important to ensure that your environment is conducive. This includes getting a comfortable mattress and pillows to ensure that you get quality sleep during the night.

If you are suffering from insomnia and you don’t want to take medication this is the treatment for you.