Trouble sleeping at an older age is something that comes for most people after a certain age, however these problems could be worsened if an individual is also suffering from Alzheimer’s Disease.
One of the many difficulties that comes with Alzheimer’s could be insomnia or trouble sleeping. According to the National Institutes of Health, 25 to 35 percent of individuals with Alzheimer’s disease have problems sleeping.
There are a number of reasons why Alzheimer’s may be affecting your sleep schedule such as anxiety, agitation, sun-downing or even a problem with medication that is being prescribed. Regardless of the exact issue at hand, there are steps you can take in order to try to remedy this and get a good night’s sleep.
Anxiety and Agitation
According to the Alzheimer’s Association, about 20 percent of people will experience agitation, anxiety and confusion late in the day that could affect an individual’s sleep cycle. There are a number of reasons that one may suffer from anxiety or agitation. Biologically, someone suffering from Alzheimer’s symptoms or another form of dementia is experiencing a loss of their ability to understand and accept new information.
Some situations that could cause this include a change of environment, moving to a new residence, travel, fatigue from trying to make sense of everything. Some things that one can do to prevent or reduce agitation and anxiety would be to create a calm and comfortable environment and provide an opportunity for exercise.
Providing a proper environment can go a long way, being sure that disruptive television or glares aren’t present are a few things to consider. Exercise can include a walk or low-stress activity such as dancing.
Among the 20 percent that experience confusion late in the day, many of those instances could lead to sundowning. The Mayo Clinic describes sundowning as “a state of confusion occurring in the late afternoon and spanning into the night. Sundowning can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions.” Sundowning is a disturbance in the circadian rhythm can lead to wandering and pacing for those affected by it and is more prevalent in the those experiencing the middle to late stages Alzheimer’s.
Some research suggests that a low dose of melatonin along with exposure to bright, obtrusive light during the day can help to ease the problems with sundowning. Also, purchasing a therapy light could help ensure that the circadian rhythm stays balanced. A few remedies that can help to remedy sundowning would be to limit daytime napping, keeping a nightlight, playing gentle music or relaxing sounds.
Medication Side Effects
The AARP lists 10 types of medication that can cause insomnia. The list included: alpha-blockers, beta-blockers, corticosteroids, SSRI antidepressants, ACE inhibitors, ARBs, cholinesterase inhibitors, H1 antagonists, glucosamine/chondroitin and statins.
Alpha-blockers are prescribed for a number of reasons including high blood pressure. They affect sleep because research says that they can interrupt REM sleep which can affect a person’s dream cycle.
Beta-blockers are prescribed to combat high blood pressure and abnormal heart rhythms. Beta-blockers have been associated with awakenings at night and nightmares due to inhibiting the nighttime secretion of melatonin.
Corticosteroids are prescribed to treat inflammation of the blood vessels and the muscles. Corticosteroids can affect sleep cycle through the adrenal glands which are used to trigger your fight-or-flight response.
SSRIs are used to treat mild to severe forms of depression. It is unknown how SSRIs affect sleep so negatively. However in 10 to 20 percent of people prescribed SSRIs, they have found agitation and insomnia as two side effects.
ACE Inhibitors are prescribed to treat blood pressure, congestive heart failure and other conditions. Sleep trouble occurs because ACE inhibitors boost the levels of bradykinin in the body and bradykinin has been thought to cause hacking and dry cough which can keep someone awake.
ARBs are used to treat coronary artery disease or heart failure in patients whose bodies can’t tolerate ACE inhibitors. ARBs cause insomnia by leading to a potassium overload in the body that can cause leg cramps, diarrhea, achy joints and muscles.
Cholinesterase inhibitors are used as a medication to treat memory loss and mental changes in relation to Alzheimer’s and dementia. The medications work by breaking down acetylcholine, a neurotransmitter in the body, which boosts the amount of available brain cells. However, breaking down acetylcholine can lead to involuntary body processes and movements. Other side effects include nausea, changes in heart rhythm and vomit which can also affect sleep patterns.
H1 antagonists, which are in a class of drugs more commonly known as antihistamines, suppress histamines which is the chemical that is released when you have an allergic reaction. Similar to Cholinesterase inhibitors, H1 antagonists block acetylcholine in the body which can lead to insomnia.
Glucosamine and Chondroitin are dietary supplements that are prescribed to relieve joint pain and lessen inflammation, something that occurs with arthritis. Gastrointestinal side effects like nausea, diarrhea as well as headaches are side effects of the medication and can cause sleep problems.
Statins are prescribed to patients to treat high cholesterol. A common side effect from Statins is muscle pain which can cause restlessness, the worst cases of which can be immobilizing.
While medication may be a contributing factor or the sole factor, in some cases to the insomnia or sleep problems an Alzheimer’s patient is suffering from, it is recommended that creating a time to take the medication and sticking to that schedule could help get over this problem. Similarly, not taking the medication right before bed could also help prevent insomnia from occurring.
How to Help a Loved One
While you may not personally be suffering from this problem, someone you love might be. If this is the case, and you are with them when one of these episodes occurs here are a few tips from the Alzheimer’s Association that you can use.
- Approach him or her calmly and make sure that they are safe
- Ask him or her if there is anything they need
- Gently remind the person of the time
- Avoid negative interaction like arguing
- Offer reassurance to him or her that everything is alright and everything will be fine
- Do not use physical restraint
- If the person needs to pace, allow them to under your supervision
If a loved one does wake up in the night while you are present it is recommended that they get out of bed rather than stay up and awake while laying in bed. This will reinforce that the bed is for sleep.
These are just a few of the tips you can try to help yourself or a loved one with this problem. If you are looking for a senior living facility for your family member that will support their senior health without breaking the bank give Landmark Senior Living a look. It is available today to take you and your loved one for a tour at one of our seven premier and affordable communities. Call now for more information!