The days will soon begin to get noticeably longer, courtesy of Daylight Saving Time. On Sunday, March 12 at 2 a.m., set your clock forward one hour to 3 a.m. Daylight Saving Time, first observed in the United States in 1918, has a real impact on our circadian rhythms, and research supports a relationship between sleep issues and dementia risk. Sleep pattern changes – like those we experience during Daylight Saving Time – have been shown to affect different aspects of our physical and psychological health.
New research is published regularly on sleep-related dementia risk factors, including:
• Regular healthy sleep may remove beta- amyloid from brain tissue, a toxic protein renowned for accumulating in the brains of patients with Alzheimer's disease.
• More frequent use of sleep medications may be associated with a higher risk of dementia.
• Research suggests that poor sleep habits in mid and late life may increase the risk of developing dementia.
• Individuals who sleep less than the recommended amount are at higher risk for developing dementia.
• Obstructive sleep apnea may increase the risk of Alzheimer's disease.
Sleep disturbances are common among people with Alzheimer’s and other dementias. It has been reported that up to 25% of people with mild to moderate dementia and up to 50% of people with severe dementia may have sleep problems. Many people with Alzheimer’s wake up more often and stay awake longer during the night. They may become restless or agitated in the late afternoon or early evening, an experience often called “sundowning,” which can disrupt the sleep of their caregivers. Experts estimate that in the late stages of Alzheimer’s, individuals spend about 40% of their time in bed at night awake and a significant part of their daytime sleeping. This makes their lives more stressful and exhausting, but there are effective ways for caretakers to manage sleep issues.
• Keep the home well lit in the evening. Adequate lighting may reduce the agitation that occurs when surroundings are dark or unfamiliar.
• Make a comfortable and safe sleep environment. The person's sleeping area should be at a comfortable temperature. Provide nightlights and other ways to keep the person safe, such as appropriate door and window locks. Door sensors and motion detectors can be used to alert family members when a person is wandering.
• Maintain a schedule. As much as possible, encourage the person with dementia to adhere to a regular routine of meals, waking up and going to bed. This will allow for more restful sleep at night.
• Avoid stimulants. Reduce or avoid alcohol, caffeine and nicotine, which can all affect the ability to sleep. Discourage watching television during periods of wakefulness at night, as it can be stimulating.
• Plan more active days.
A person who rests most of the day is likely to be awake at night. Discourage afternoon napping and plan more challenging activities such as doctor appointments, trips and bathing in the morning or early afternoon. Encourage regular daily exercise, but no later than four hours before bedtime.
• Be mindful of your own mental and physical exhaustion.
If you are feeling stressed by the late afternoon, the person may pick up on it and become agitated or confused. Try to get plenty of rest at night so you have more energy during the day.
If the person is awake and upset:
• Approach them in a calm manner.
• Find out if there is something they need.
• Gently remind them of the time.
• Avoid arguing.
• Offer reassurance that everything is alright.
• Don't use physical restraint. If the person needs to pace, allow this to continue under your supervision.
If you have questions, call the Alzheimer’s Association 24/7 helpline at 800.272.3900 for more information or visit <alz.org>.
Alzheimer's Association The Alzheimer’s Association is a worldwide voluntary health organization dedicated to Alzheimer’s care, support and research. Its mission is to lead the way to end Alzheimer's and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Visit <alz. org> or call 800.272.3900.