Benzodiazepines, such as lorazepam, oxazepam and temazepam.Tricyclic antidepressants, such as nortriptyline.Food and Drug Administration (FDA) has ordered manufacturers to label such drugs with a “black box” warning about their risks and a reminder that they are not approved to treat dementia symptoms.Įxamples of medications used to treat sleep changes include: Research has shown that these drugs are associated with an increased risk of stroke and death in older adults with dementia. The decision to use an antipsychotic drug should be considered with extreme caution. The type of medication prescribed by a doctor is often influenced by behaviors that may accompany the sleep changes. If sleep medications are used, an attempt should be made to discontinue them after a regular sleep pattern has been established. They include increased risk for falls and fractures, confusion and a decline in the ability to care for oneself. The risks of sleep-inducing medications for older people who are cognitively impaired are considerable.

For those individuals who do require medication, experts recommend that treatment “begin low and go slow.” In some cases, non-drug approaches fail to work or the sleep changes are accompanied by disruptive nighttime behaviors. Our Alzheimer’s & Dementia Caregiver Center brings our caregiving information and tools together into one easy-to-navigate site featuring information on early-, late- and middle-stage caregiving and other topics.

Discourage watching television during periods of wakefulnessĬope with caregiving challenges and changes.

If the person awakens, discourage staying in bed while awake use the bed only for sleep.

Provide nightlights and security objects.

Make sure the bedroom temperature is comfortable.

If the person is taking a cholinesterase inhibitor (tacrine, donepezil, rivastigmine or galantamine), avoid giving the medicine before bed.

Encourage regular daily exercise, but no later than four hours before bedtime.

Maintain regular times for meals and for going to bed and getting up.

To create an inviting sleeping environment and promote rest for a person with Alzheimer’s: Non-drug coping strategies should always be tried before medications, since some sleep medications can cause serious side effects. Non-drug treatments aim to improve sleep routine and the sleeping environment and reduce daytime napping. Use of sleep medications is associated with a greater chance of falls and other risks that may outweigh the benefits of treatment. Studies have found that sleep medications generally do not improve overall sleep quality for older adults. Most experts and the National Institutes of Health (NIH) strongly encourage use of non-drug measures rather than medication.

Sleep apnea, an abnormal breathing pattern in which people briefly stop breathing many times a night, resulting in poor sleep qualityįor sleep changes due primarily to Alzheimer’s disease, there are non-drug and drug approaches to treatment.

Restless legs syndrome, a disorder in which unpleasant “crawling” or “tingling” sensations in the legs cause an overwhelming urge to move them.

Examples of conditions that can make sleep problems worse include: Contributing medical factorsĪ person experiencing sleep disturbances should have a thorough medical exam to identify any treatable illnesses that may be contributing to the problem. In extreme cases, people may have a complete reversal of the usual daytime wakefulness-nighttime sleep pattern. They may become restless or agitated in the late afternoon or early evening, an experience often called “sundowning.” Experts estimate that in late stages of Alzheimer’s, individuals spend about 40 percent of their time in bed at night awake and a significant part of their daytime sleeping. Individuals may feel very drowsy during the day and then be unable to sleep at night. Those who cannot sleep may wander, be unable to lie still, or yell or call out, disrupting the sleep of their caregivers.ĭaytime napping and other shifts in the sleep-wake cycle. Brain wave studies show decreases in both dreaming and non-dreaming sleep stages. Many people with Alzheimer’s wake up more often and stay awake longer during the night. Sleep changes in Alzheimer’s may include:ĭifficulty sleeping.

There is evidence that sleep changes are more common in later stages of the disease, but some studies have also found them in early stages. Many older adults without dementia also notice changes in their sleep, but these disturbances occur more frequently and tend to be more severe in Alzheimer’s. As with changes in memory and behavior, sleep changes somehow result from the impact of Alzheimer’s on the brain. Scientists do not completely understand why this happens. Many people with Alzheimer’s experience changes in their sleep patterns.

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