Should I let my mother with dementia sleep all day?

Cathyf asked...

My mother is having major sleeping issues. She sleeps until 11 and then takes 2 hours to fully wake up. By this I mean that I finally get her in the living room and she is nodding off to sleep every ten minutes Should I let her sleep or keep waking her up? By 4 P.M she is awake and between 4-8 she is at her best. Then she is ready to go to sleep at about 9, but she is constantly getting up and down all night. What I want to know is if this is normal behavior for someone with Dementia and how am I supposed to handle it?

Expert Answer

Deborah Cooke is a gerontologist specializing in dementia, delirium, caregiving, and senior fitness. She is a certified dementia care provider and specialist through the Alzheimer's Foundation of America. Cooke currently manages several multidisciplinary programs to enhance well-being for hospitalized seniors and other vulnerable patients at NewYork-Presbyterian Hospital in New York City. She also serves on the board of NewYork-Presbyterian's Patient and Family Education Advisory Committee. She has 18 years of experience working with the aging and caregiver communities.

Sleep changes in dementia individuals is not uncommon, even though it is extremely frustrating. Ask yourself these questions:

  1. Does this behavior seem to bother her, make her agitated, experience difficult behaviors?
  2. Is this a normal routine for her based on her previous habits before dementia?
  3. Does this behavior drive you nuts and keep you awake because of the disturbance or the crazy hours?

If the behavior seems to be harmless to her, then you may not want to deal with it. However, making sure she is exposed to light and activity during the day is very important to help with circadian rhythms. If this is a normal habit for her and always has been, then it's natural to have this behavior. The likelihood of changing this is very little and sensitivity is paramount.

You may want to review her prescriptions and over the counter medication. Have they changed and her sleep patterns start around this time? She may be experiencing drug interactions or over sedation. Talk to her physician and/or pharmacist to address her medications. I'm not a fan of "sleeping pills" as they tend to increase the likelihood of falls and adverse reactions.

Depending on the activity level during the overnight hours, you may see if you can get a home health aide or someone in to help her during those hours. They can keep her stimulated during those times and the sleeping during the day will be more natural and maybe less frustrating.

Finally, there are adult day centers that have overnight programs. This option would give her stimulation and allow you to get a good night's sleep. You can access the following for additional information on this program:

Area Agency on Aging

Elder Care Locator

I hope one of these will be helpful. Let me know how it turns out.