This is the rhythm of the night
Oh night
The rhythm of the night
This is the rhythm of my life
— song lyrics, Corona
In our field of dementia care, we often say “if the night goes well, so will the day.” Many people living with dementia experience sleep disturbances that affect their quality of life. It can be both difficult to discern the underlying cause and find what helps. As caregivers, we can be astutely aware of the rhythms of the day and night, and make a difference with sleep.
As we all understand from personal experience after a good night’s sleep, we feel recharged. And after a poor night’s sleep, we feel foggy and irritable. Sleep time is critically important to brain health as it helps reduce inflammation. Recent studies are showing a strong connection of inflammation in the brain and risk of Alzheimer’s Disease. Sleep also allows the hippocampus, our brain’s supercomputer memory chip, to transfer memories to the cerebral cortex, helping us with memory recall.
When a loved one is living with dementia, those caring for them are living with it too, and are affected by restlessness nights. We can take helpful steps to better sleep with activities that work well with the rhythm of the day and of the night.
1. Nutritious and hydrating meals will provide the energy needed for being active and give some structure to the day when meals and snacks are served at consistent times. That said, it will help to eliminate caffeine, reduce fluid intake in the evening and avoid late night meals. Include fruit and veggies for fiber, or use a fiber supplement, to help with bowel health — constipation can lead to sleeplessness!
2. Activities that are enjoyable and include movement help with a daytime rhythm that can lead to better sleep. It turns out that brain and brawn actually do go together. Exercise can be modified to the abilities of each person, and appears to help the brain’s neurotransmitters to regenerate. Whether it is a morning chair Tai Chi routine, an afternoon walk, balloon volleyball, or dancing to disco music, 20 minutes can make a difference.
3. Creating an evening ritual that helps your loved one to wind down from their day can be comforting and helpful for sleep. Read uplifting short stories, listen to relaxing music, watch a nature documentary together or work on a puzzle. Aromatherapy can be a part of your ritual and there are many wonderful choices such as lavender creams or oils used in a diffuser. One of the best parts of aromatherapy is that everyone walking through the room benefits. My favorite cream is Aurum Lavender Rose by Uriel, and locally made lavender hand cream by the Soap Cauldron.
Notice I haven’t yet mentioned sleep supplements or medications. We try non-medication approaches for as long as possible, and when the need for good sleep is still not met, being seen by the primary care physician is the next step.
Sometimes, the destruction of the brain’s cells, whether by Alzheimer’s plaques and tangles or by vascular impairment, seems to cause sleep disruption. There may be other health issues that need to be addressed by the primary care doctor that are affecting sleep, such as pain or acid reflux. Medication may be needed for the wellbeing of your loved one with the advice and insight of their physician. Keeping a daily activity/sleep log and a record of daily medications will help with finding a helpful approach to sleep. Knowing the side effects of sleep medications will be essential for safety, and know that you can return to the doctor if sleep has not yet improved.
Medical cannabis producers and physicians are also making a difference with sleep disturbances and we are now seeing very effective, low dose and balanced tinctures help with very little to no negative side-effects. Herbal remedies such as camomile or valerian have been around a long time and many of our residents have used them much of their lives.
The goal is having well-being while living with dementia, and that means learning all of the time, listening to one another, and being persistent. All of this requires a supportive community with members from different perspectives, disciplines and abilities who are willing to help solve the many problems, like sleeplessness, that we experience with dementia care. Please feel free to share what has worked for you.