Dementia and sleep issues typically take a toll on both the patient and their caregiver. Falling and staying asleep becomes increasingly difficult for elderly adults with dementia — and when a loved one with dementia is up at night, so are their caregivers.

Understanding the underlying causes of sleep issues can help you identify methods and treatments for helping a dementia patient rest through the night.

Why dementia patients don’t sleep at night

A number of factors may contribute to restlessness or insomnia and dementia, though they differ from patient to patient. And while there’s no known exact cause, dementia-related damage to the area of the brain that regulates the body’s internal clock appears to play a role in dementia and sleep disturbances.

Changes to that particular part of the brain can throw off a person’s circadian rhythm and make it difficult to maintain a normal sleep-wake cycle. As a result, a person with dementia often experiences sleep-filled days and restless nights.

Other factors that can result in a person with dementia not sleeping include:

  • Medication side effects
  • Excessive napping or sleeping all day
  • Chronic pain or a health condition such as a urinary tract infection (UTI)
  • Not getting enough physical activity or light exposure during the day
  • An uncomfortable sleeping situation, such as a bedroom that’s too hot or cold

Common sleep problems in elderly patients with dementia

Sleep disorders such as insomnia, sleep apnea, and restless leg syndrome (RLS) are all frequent sleep disturbances in people with dementia. Yelling at night or talking in their sleep may also occur in dementia patients, and it could indicate an underlying health problem or pain they can’t communicate verbally during waking hours.

Some nighttime dementia behaviors can be especially upsetting for sleep-deprived caregivers — and potentially dangerous for dementia patients. Sundowning symptoms, such as increased agitation and restlessness, generally begin later in the day and can contribute to sleeplessness at night. Someone with dementia may wander or try to leave their home. This could be because they’re unable to recognize their surroundings and are looking for something familiar to orient themselves.

Sleep aids for dementia patients

In some cases, doctors may prescribe sleeping pills for dementia patients, but these medications may increase a senior’s risk of falling. Non-drug solutions, such as those listed below, are generally recommended before pursuing anti-anxiety or antipsychotic drugs to treat insomnia in dementia patients.

While sleeping pills and dementia aren’t always a good mix, natural supplements like melatonin may help improve sleep quality and regulate a person’s sleep cycle. Melatonin is an over-the-counter sleeping aid that can be used for elderly patients with dementia.

Be sure to check with your loved one’s doctor about potential drug interactions before adding any medications, vitamins, or supplements to their regimen.

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How to keep dementia patients in bed at night

Adjusting the environment and trying non-drug-based sleep strategies are often the best methods for helping calm dementia patients down at night. Additionally, do your best to prevent a dementia patient from sleeping during the day, if possible.

Try keeping them awake with an activity they enjoy, such as going to the store or taking a drive somewhere. These strategies can also help dementia patients sleep at night and improve their sleep quality:

  • Limit daytime naps to 30 minutes.
  • Review medications for side effects.
  • Look for any causes of pain or discomfort, such as bedsores.
  • Avoid caffeine, alcohol, and other stimulants.
  • Limit liquids a few hours before bedtime.
  • Increase physical activity and sunlight exposure during the day.
  • Establish a regular routine with consistent times for eating, sleeping, and waking up.
  • Create a tranquil sleep environment in a cool, quiet space with minimal light exposure.

When dementia sleep issues keep caregivers up at night

Sleep deprivation is widespread among family caregivers, and about 90% of dementia caregivers experience sleep problemsNot only can lack of sleep contribute to caregiver burnout, but it can also affect your decision-making abilities and lead to accidents.

So if neither of you are sleeping well, and nothing seems to be helping, what’s next?

In-home care services can be a great resource for tired caregivers who wish to keep a loved one at home. Some home care agencies offer around-the-clock care or overnight care aides to help family members get the rest they need. Services are typically customizable and can easily accommodate a family’s busy schedule.