How would you rate their sleep quality?
Are they sleeping a lot during the day and then not very much at night?
Are you worried that they are not well-rested when they wake up in the morning?
Getting a good night’s sleep is critical for good brain health, yet many older adults experience trouble sleeping. Our brains have a core circadian clock that keeps us on a 24-hour cycle, telling us when to wake and when to sleep.
This internal clock changes as we age and sometimes needs a bit of help to get us ‘sleeping like a baby’ again.
Our Molecular Clock
A recent study at the Pittsburgh School of Medicine looked at the effects of normal aging on the molecular rhythms in the frontal cortex of the brain. The frontal cortex is an important part of the brain. It is area of the brain responsible for executive functioning like making good decisions and exercising sound judgement.
In this study, scientists identified 235 core genes that make up the molecular clock in our brains. They found that younger people have the daily circadian rhythm in all the classical “clock” genes while older people’s “clock” genes tend to lose this rhythm.
As we age, our circadian rhythm can get out of synch and our sleep patterns can become disrupted.
Disrupted Sleep and Dementia
As well, other research shows an association between disrupted sleep and dementia. It seems like a vicious cycle. Disrupted sleep leads to brain changes which lead to disrupted sleep patterns – and the cycle continues. Breaking the disrupted sleep pattern is an important step in slowing down the development of negative brain changes.
Sleep disorders and dementia go hand in hand.
It is estimated that between 40 – 60% of people with dementia also have a sleep disorder.
And sleep disorders interfere with cognitive functioning and increase the risk of falls. Sleep disorders also increase the risk of depression and aggressive behaviour.
Getting treatment for this underlying disorder has a positive effect on cognitive functioning. Good sleep will also improve quality of life.
Caregivers Need Sleep Too
Individuals providing care also require a good night’s sleep. It is difficult to remain patient and focused when you are suffering from fatigue. It is also much easier to become sad and feel overwhelmed when you are suffering from a bad night (or many bad nights) of poor sleep.
And it is very frustrating when the one you care about is having trouble sleeping. Watching them struggle to stay awake during the day or wake-up exhausted can be very distressing.
While speaking to your doctor is an important step, there are things you can do to improve their sleep habits.
Improve Sleep Quality by Addressing Sleep Problems
There are four main areas that you should consider in trying to address sleep problems.
Increase their daytime activity, both intellectual stimulation and light physical exercise.
Enjoyable daytime activities increase the production of hormones and chemicals that improve mood and decrease anxiety. So make sure you have enough physical and mental activity to bring your mom or dad to the end of the day pleasantly tired.
One of the most disturbing times of day for individuals with dementia is late afternoon and early evening. At this time of day symptoms of sundowning may occur. Increasing daytime activity can help reduce this agitation at the end of the day.
Providing appropriate intellectual activity for individuals with dementia can be challenging. Taking part in a group cognitive stimulation program or working one-on-one with a Fit Minds Coach is a great way to get good intellectual stimulation.
Physical activity is also important. Getting the body moving can improve circulation and digestion. Physical activity can also reduce joint stiffness and pain, and improve sleep quality.
A Structured Day
A daily activity routine helps prevent or reduce daytime napping. This will help the individual be more ready to sleep at the end of the day. When planning activities, spread them out throughout the day to avoid your mom or dad becoming overtired. You should also avoid activity close to bedtime, which can be overstimulating.
Motivation to be active can be lacking, particularly after meals. Upbeat music can have a positive effect and encourage your mom or dad to participate in activities.
Good sleep hygiene or habits are essential for a good night sleep. Some ideas for creating an environment conducive to getting a good night’s sleep are:
1. Have a fixed time to go to sleep and a fixed time to wake-up that are the same every day. This will create a habit and expectation in your brain that it is time to go to sleep.
2. Create a bedtime ritual – play a certain piece of music, use a specific hand lotion, have a bedtime snack that is the same each night. All these cues help the body recognize that it is time to go to sleep;
3. Avoid caffeine, alcohol and very spicy foods 4 to 6 hours before bedtime. Caffeine can impact the body’s melatonin production, which is an important chemical required for sleep.
4. Use passive body heating to signal to the brain it is time to go to sleep. Raise your body temperature through a warm bath, shower or a hot water bottle on the lap or torso. Once the heat source is removed, your body temperature will drop, signalling the brain that it is time to go to sleep.
The Sleep Environment
The bedroom environment can also impact the quality of sleep. Ensure the bedroom is well set-up for sleep. Some tips to improve the bedroom’s sleep-inducing qualities are:
1. Have the overnight temperature a bit cool;
2. Keep the room well ventilated; and,
3. Run a fan that creates neutral ‘white’ noise that can help block out disturbing sounds.
Bright Light Therapy Can Improve Sleep Quality
The body’s sleep/wake cycle is strongly influenced by the melatonin hormone, which is created by the exposure of the eye to bright light. Bright light therapy has shown good results in improving the sleep/wake cycle for individuals suffering from sleep problems and regularizing sleep patterns.
Research shows that bright light therapy has also had very good results in helping the brain heal from mild traumatic brain injury.
The best source of bright light is natural daylight – so getting outside every day is essential for a good night’s sleep.
If that is not possible, there are other options such as the use of blue spectrum lights. You can purchase blue spectrum lights at home health stores.
You may also find that where you live has an impact on the amount of daylight that is reasonable or practical for you to get exposure to. In the middle of winter in many parts of Canada and the northern United States it is almost impossible to get sufficient exposure to natural daylight.
If you are using bright light therapy, the best time to be exposed is before 11am. This will increase daytime alertness. Remember, bright light lamps should not be used after 4pm. This can increase evening agitation and make it difficult to settle. Check with your pharmacist for the best way to use a bright light lamp in your particular circumstances.
Sleeping well helps our body and brain repair and recover from the stresses and strains of the day.
Take the time to create a framework for good sleeping patterns. You will see a positive impact on the quality of life for your mom or dad.