Battling Caregiver Sleep Deprivation: What Can You Do?

When your loved one has dementia, it can make nighttime rocky, but there are ways to improve both your sleep routines.

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- Posted on Oct 8, 2020

A woman waking up in bed during the morning.

Restful and adequate sleep is one of the most precious—and often elusive—commodities for caregivers. As vital as it is to your well-being, getting a satisfying night’s slumber can be a tall order. Even when you’re exhausted, it’s tough to switch off a mind that’s spinning with the stresses of the day. The additional demands of work and children can compound the challenge.

When your loved one has Alzheimer’s disease, you may also be dealing with sleep disturbances on his or her part, including “sundowning” behavior. The name derives from the fact that many people with Alzheimer’s experience agitation later in the day and frequently have difficulty falling asleep and/or staying asleep after they’ve gone to bed. For you as a caregiver, this can mean even more stress as the day winds down, possibly followed by nightly interruptions, so it’s important to do what you can to get a handle on your own sleep, as well as your loved one’s.

As a caregiver, sleep deprivation can put you at risk for health problems and make driving or physical activities more hazardous. In turn, exhaustion or burn-out affect your ability to care for your loved one. Your patience can wear thin and your loved one may sense your stress and become agitated. There are a number of ways, however, to help improve the quality of your sleep and to get the sleep you need.

Research by the University at Buffalo School of Nursing found that more than 90 percent of people caring for a family member with dementia experience poor sleep. Most participants in the study, published in 2018 in Perspectives in Psychiatric Care, got less than six hours of sleep each night, accompanied by frequent awakenings as often as four times per hour.

“These disruptions can lead to chronic sleep deprivation and place caregivers at risk for depression, weight gain, heart disease and premature death,” reported lead author Yu-Ping Chang, PhD.  And, more than 80 percent of people with dementia will also experience sleep disturbances, anxiety and wandering. These disruptions have negative effects on caregivers' health, too.

Sleep disturbance tend to get worse as dementia progresses in severity, according to the Mayo Clinic website. Excessive sleepiness during the day and insomnia with difficulty falling asleep and staying asleep are common problems, along with frequent awakenings in the night and waking up prematurely. Those who experience sundowning may feel confused, agitated, anxious and aggressive during the evening or night.

You are affected, of course, by your loved one’s sleep disturbances, as well as the additional stresses of caregiving.

In order to give yourself some respite, remember that it’s okay to ask family members or friends for assistance with nightly caregiving. Check with your local Alzheimer’s Association for support in your area. You may also want to look into hiring an at-home caregiver to relieve you at night or to take on some of your tasks so that you don’t feel as stressed. These professionals are trained to sensitively handle the needs of people with a variety of conditions, including dementia. Ask your loved one's doctor about whether it's a good idea to bring someone in the home now to help and ask about the safety protocols at any agency you contact. If you can't hire someone now, this may be a good time to begin research options for the future.

Regardless of whether you have extra help with caregiving, taking steps to improve your loved one’s sleep can help you both get more rest.

You can start by helping your loved one to:

  • Maintain regular times to wake up, eat meals and go to bed.
  • Take in some morning light exposure.
  • Get daily exercise, like a walk in the neighborhood or simple stretches. It’s best to undertake activities that uses more energy early in the day. This can include anything from bathing to eating a family meal.
  • Avoid alcohol, caffeine or nicotine.
  • Keep daytime sleep to a minimum, as afternoon napping can lead to a restless night.
  • Enjoy calming activities in the evening. You may want to read out loud, look through photos together or play peaceful music. Discourage TV watching before bedtime. A comfortable bedroom temperature is also soothing.

Try to remain calm when your loved one does wake up, even though it can be tough when you’re exhausted. Ask what the issue is, and if he or she needs to pace, allow it under your supervision.

Speak with a doctor if you think that a medication or an underlying condition, like pain, sleep apnea, depression or restless leg syndrome, may be at the root of a sleep disturbance.

As with your loved one, you can promote better sleep for yourself by having a regular waking and bedtime routine, exercising regularly, abstaining from caffeine and alcohol before bedtime, and setting a comfortable bedroom temperature.

These additional tips may also help you to get the rest you need:

  • Establish a bedtime that allows you to get at least seven hours of sleep.
  • Don’t go to bed unless you’re sleepy, and if you’re still awake after 20 minutes, get up and do something relaxing in low light. This helps to avoid a connection between your bed and frustration from sleeplessness.
  • Snack on something light and healthy if you have hunger pangs at night, and try not to drink too many fluids.
  • Keep evening exposure to bright light and noise at a minimum. At least a half hour before bedtime, shut off electronic devices.
  • Consider calming scents in the bedroom, including essential oils like lavender. Quality bedding, mattresses and pillows also make a difference.

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