Sleep disturbances are common in Alzheimer's disease. Broken sleep can affect everyone in the home so it is perhaps not surprising that often becomes a contributory factor to people being placed in a care facility. Care facilities present their own difficulties. Noise levels are often higher, there is frequent movement of objects and people during day and night, and the size and design of the building can be confusing.
Caregiving in the home may seem to have the advantage over care in a facility but each has its own strengths. When it comes to care at night most care homes tend to have diminished numbers of staff, even in care homes specifically catering for people with dementia. This is relevant because even where there is an expectation that sleep disturbances will create disruptive behavior, insufficient staff can only cope to a limited extent. For this reason, there can be an over reliance on sedatives and tranquilizers.
Care staff and caregivers share a common problem when it comes to reducing sleep disruptions. There are a few general tips however that can be useful for both:
1. Day staff can help by encouraging activities and discouraging over-long naps.
2. Routines are quite important so try to keep the sequence of events more or less the same when it comes to bedtime, and try to encourage bedtime at a broadly similar time each evening.
3. Prepare by closing blinds and curtains and switching on lights. Try to keep light levels dim, but not so dim that it compromises health and safety. Remember that older people tend to need higher lighting levels than younger people in order to see properly.
4. Set the scene for bed by switching off television or at least turning the volume down. Consider alternatives like relaxing music. Offer a small, warm, non-stimulating drink and a snack as these can encourage sleep. Don't give too much in the way of fluid before bed.
5. Once everyone is in bed keep noise levels to a minimum. Don't talk near people who are sleeping and avoid switching lights on and off. Consideration should also be given to flooring and footwear. Flooring without carpets is invariably noisy as are some shoes.
6. If the person wakes up during the night, adopt a quiet reassuring tone. If they are confused, or if you are aware of some physical problem such as prostate enlargement, take them to the bathroom. Keep the level of stimulation low and perhaps quietly remind the person that it is night-time and how you don't want to wake others up. Escort the person to bed and again wish them a good night's sleep.
7. If the person still gets up, try changing the environment. Take them to sit in a chair but don't switch on the television. Keep the person warm and after a few minutes try again.
As we age it is quite common for our sleep routines to change. Older people will often nap more in the day and sleep less at night. It is quite normal for the elderly to go to bed in the early evening and wake quite early in the morning. It is not always easy to meet the needs of every individual in a care facility and some concessions need to be made in terms of the routines that residents adopt. Only if these routines disrupt the sleep of others should advice from medical staff be sought.