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

Click here to open Certificate of Completion

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