08: Sleep: Promoting Healthy Sleep Patterns

This program will present principles and strategies for:

  • Improving sleep patterns
  • Creating an environment that promotes sleep
  • There are no easy answer when its comes to the care of another
  • Our hope is to offer you useful information and guidelines for caring for someone with dementia
  • These guidelines will need to be adjusted to suit your own individual needs

Sleep issues associated with Alzheimer’s Disease,

  • Spend more time awake at night and sleeping during the day
  • Wake up during the night to wander
  • Wake up confused, disoriented, frightened, or feeling alone
  • Delusions and hallucinations disrupt sleep patterns

What can Mary expect as she cares for her husband with Alzheimer’s disease?

  • A. Robert will wander off at times.
  • B. Mary needs to adjust to not sleeping through the night.
  • C. Mary needs to make adjustments to how she cares for Robert.
  • D. Robert will sleep during the day and stay awake during the night.

Choice A: Robert will wander off at times, is a good choice.

  • Try to meet the needs of persons with dementia before wandering occurs
  • Dedicate wandering areas within the home that are free of stairwells, clutter, dangerous objects and chemicals

Choice B: Mary needs to adjust to not sleeping through the night, is a possibility.

  • Lack of sleep is one of the main reasons caregivers place family members with dementia in long-term care facilities

Choice C: Mary needs to make adjustments to how she cares for Robert, is the best answer.

Choice D: Robert will sleep during the day and stay awake during the night, is a possibility.

  • Practicing good sleep habits may prevent the reversal of day and night sleep patterns
  • Learn about how dementia and aging affect sleep patterns
  • Keep a sleep journal
  • Talk to a healthcare professional

To learn more about keeping a sleep journal

Keep Track of:

  • Number, length, and timing of naps during the day
  • Time to bed at night
  • Time to rise in the morning
  • Number of awakenings at night, at what time, for how long and for what reason
  • Anything given before bed
  • Rate the person’s sleep
  • Difficult night: No sleep or very little sleep (less than 2 hours)
  • Poor night: Little sleep (2-4 hours)
  • Fair night: Multiple, brief (less than 30 minute) awakenings but more than 4 hours of total sleep
  • Good night: Only a brief (less than 30 minute) awakening

Topics to discuss:

  • Specific health problems that may be affecting sleep
  • Feelings of depression, sadness, or anxiousness
  • Current medications and their side effects
  • Changing medications that might interfere with sleep
  • Non-drug approaches to promoting better sleep patterns
  • Starting new medications that promote sleep
  • Keep regular routines
  • Limit daytime napping
  • Discourage the person from staying in bed while awake, watching television, or reading
  • Discourage the person from falling asleep while watching television
  • Minimize pain, fatigue and discomfort
  • Look for and attend to other causes of discomfort
  • Establish a comfortable, familiar, and secure sleeping environment
  • Room temperature
  • Extra blankets
  • Clean linens and pajamas
  • Security objects within reach
  • Nightlights or soft, dim lighting
  • Provide a pleasant atmosphere in the bedroom
  • Familiar objects and people
  • Calming music
  • Relaxing fragrances
  • Melissa oil (lemon balm)
  • Lavender oil

Activities that promote healthy sleep patterns

  • Get sunlight exposure and/or bright light therapy
  • Exercise regularly
  • Physical activity should be interspersed with quiet activities

Foods that Interfere with Sleep

  • Prevent excessive evening fluid intake
  • Restrict the use of alcohol
  • Prevent caffeine intake in the late afternoon and evening
  • Avoid tobacco
  • Avoid heavy or rich food late in the evening
  • Dairy products
  • Cottage cheese, cheese, milk
  • Soy products
  • Soy milk, tofu, soybean nuts, edamane
  • Rice, whole grains and oats
  • Beans, hummus, lentils
  • Nuts
  • Hazelnuts, peanuts, almonds, walnuts
  • Eggs
  • Sesame seeds, sunflower seeds
  • Seafood
  • Tuna, halibut
  • Poultry
  • Fruits and vegetables
  • Pumpkin, artichokes, avocados, peaches, apricots, asparagus, potatoes, bananas

Guidelines for using sleep-promoting medications

  • Give the lowest possible effective dose
  • Give only when necessary rather than on a scheduled basis
  • Never give more than the maximum dose prescribed
  • Once a regular sleep pattern has been established, try to decrease and discontinue the medication
  • Changes to medication regimens should be done under the supervision of a physician
  • Dementia can cause sleep disturbances
  • Talk to a healthcare professional
  • Keep a sleep journal
  • Promote healthy sleep habits
  • Avoid stimulating foods in the evening
  • Provide sleep-promoting foods in the evening
  • Create an environment that promotes sleep
  • Try activities that promote healthy sleep patterns

Written by:
Catherine M. Harris, PhD, RNCS.
Mindy J. Kim-Miller, MD, PhD

Edited by:
Sasha Asdourian

www.LightBridgeHealthcare.com

07: Caregiver Stress: Coping Strategies

Select the best answers from the list of choices following each question.

Click here to open Certificate of Completion

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