Caring for a person with Alzheimer’s disease or dementia is difficult enough without adding the additional stress that comes when you can’t sleep. Sleep problems can be the cause, effect, or complication of illnesses, mental disorders, and accidents. Just like temperature, pulse, and respiration, sleep should be considered a vital sign of health. The quality of one’s sleep cycle of sleep and wakefulness can be a sign of health or illness.
Primary insomnia is sleeplessness that cannot be blamed on mental disorders, physical illness, medications or simple problems with scheduling. Excessive daytime drowsiness (called primary hypersomnia) is associated with nighttime periodic leg movements, restless led syndrome, sleep apnea (pauses in breathing during sleep), and snoring. Periodic leg movement disorder and restless leg syndrome are also associated with complaints of insomnia and non-restorative sleep. In either case, to qualify as a sleep disorder, symptoms must interfere with social or intellectual function and occur three nights per week for a month.
Obsessive worry about sleep and the use of alcohol or sedatives may be both a cause an and effect of insomnia. An occasional sleep problem can become persistent by self-defeating solutions such as spending too much time in bed, abandoning a regular schedule of sleep and waking, or using alcohol as a sleep aid.
A few days of insomnia or restless sleep can be the result of a simple illness like the common cold or a change in routine, like staying in a hotel. However, insomnia lasting four weeks or longer likely has a more complex cause. Older adults with insomnia that lasts four weeks or longer should consult a physician.
Questions You and Your Doctor Should Consider: If you are concerned about the quality of your sleep, talk to your doctor if:
- You have difficulty falling asleep and staying asleep
- If you do not feel rested upon awakening
- If you feel sleepy or fatigued during the day
Be sure to tell your doctor how long you have had problems sleeping. The length of symptoms is important for diagnosis and treatment. Also tell your doctor about your sleep habits and any medications, illnesses or recent events that may contribute to your sleep difficulties. In particular, you may wish to discuss:
- How many time you wake each night to care for the person with Alzheimer’s disease and how long it takes for you to return to sleep
- How often you have to visit the bathroom during the night or assist the person you are caring for
- If you have any pain or difficulty breathing that interferes with sleep
- If you snore, choke or gasp while asleep
- If you are so sleepy during the day that you are at risk for nodding off or falling asleep while driving
- If you have an urge to move your legs or have uncomfortable sensations in your legs during rest or at night
- If you feel muscular tension or anxiety when trying to fall asleep
- Whether or not you have a routine such as reading or a warm bath that helps you relax before bedtime
- If you worry that you will not get enough sleep
- If you nap, how frequently and for how long
- If exercise and exposure to outdoor light is part of your daily routine
- How much caffeine, alcohol, or tobacco products you consume during the day or night
- If you use over-the-counter (non-prescription) medications or anything else as a sleep aid
- If worrisome thought intrude or prevent falling asleep or returning to sleep if you wake in the middle of the night
- If you feel sad, depressed or anxious
- Whether or not a recent life changing event may have changed your pattern of sleep
- If your caregiving responsibilities have increased or changed
In part two of Causes & Effects of Insomnia on the Alzheimer’s Caregiver, we will discuss the myths and realities about age and sleep and some useful tips for achieving healthy sleep.
Elayne Forgie has been a professional geriatric care manager for over 20 years and was a founding Board Member of the Florida Geriatric Care Managers Association. She is the President/CEO of ElderCare at Home, Inc. and The Alzheimer's Care Resource Center. Information on this website or contained in this article is not intended to replace the medical advice of your doctor or health care provider.
