Is my wife's Alzheimer's causing her to fall asleep frequently during the day?
My wife is in early to mid moderate stage. She has started to doze off quite frequently. I have noticed this happening over the last month or so. It was mostly at night around 7 or 8 pm, but now she dozes off very often during the day. She sleeps well at night and appears well rested. Is this normal with the illness? What could be causing this change? She increased her Aricept to 23mil about 3 months ago. Not sure if this may be having some effect? Her Neurologist is in office Monday and I plan on calling him to ask same question.
Dear caregiving husband:
Dementia has many different effects on people, and the drugs used to treat patients also impact behaviors and habits. I honestly cannot tell you that your wife's increased naps and dozing are due to her dementia or to drugs or a combination of both.
You've actually come up with the best approach on your own. Tell your wife's neurologist about the changes in her sleep and behavior patterns and ask him if she is possibly over-medicated or if her frequent dozing during the day is part of her "normal" decline with the disease.
It's also possible that your wife is not being socially stimulated with enough activities, visits with other people or by being part of a group at a senior center or Alzheimer's group. You might discuss these ideas with her neurologist to see what he thinks. Perhaps you'll need to increase her social stimulation to keep her both awake and more engaged in activities and life. Doing this will enhance her quality of life and fulfill a part of her day that may be missing.
I wish I could give you a more definitive answer, but as I stated, you're on the right track. With the help of the neurologist and some experimentation involving increased activities, you make find the answer to your question. Best of luck, I know you'll resolve this to your satisfaction.
My Mom is taking naps during the day, something unheard of in the past. She will lie down after a meal, or sometimes sit to watch something on TV, and falls asleep.
If she is sitting in a group setting (lives in a rest home), she watches the games, and sometimes participates, but she does stay awake!
Her rest home offers 'adult day programs' and people leave their family members while they work. I believe some families bring their loved ones for some stimulation or activities with others.
There are a few things things going on:
1) First, the nature of the disease. People with brain diseases become exhausted quickly because their brains have to work much harder in order to simply process what is going on. My research shows clearly that people with dementia need two to three rest periods each day; usually a half hour before lungh and an hour tyo 90 minutes after lunch. This helps to stabilize mood, increases night time sleep, decreases late day confusion, agitation, psychosis, and increases socialization. Another colleagues reasearch adds that no activity, whether TV or playing in a marching band, should be longer than 90 minutes.
2) People with dementia have difficulty starting and carrying through activities to reach a goal, so unless you start them into the activity and stay with them prompting until they finishe -- and then starting the next activity, they will go to sleep. This issue of boredom and the inability to know what else to do and how to sequence it is often resolved with adult day programming.
3) She may be depressed. Check with her doc about whether she might benefit from an antidepressant
4) She may have a physical illness or pain -- so an MD visit is a good idea with some blood tests and a urine sample. If she has a painful condition such as arhtritis check with your doc about giving her a mild analgesic (acetamiinophen) twice a day -- even if she is not complaining of pain.
5) It is not uncommon for people with dementia to go through a relatively short period where they sleep up to 20 hours per day. This is usually limited to a few months but you need to account for the above first.
So, in mild to moderate dementia we need to think about doing the following:
a. She should be having 2 rest periods each day; quiet times with no TV on. In moderate disease these will be naps.
b. She needs to have a routine where activities (the MOST important part of care) are built in and she receives support in starting and completing.
c. A primary care visit to rule out illness and depression
Hope this helps
Geri R Hall, PhD, ARNP, GCNS-BC, FAAN Banner Alzheimers Institute
My name is Joe, i suffer from AD and FTD now about 5 years in and I have started to sleep at the drop of a pin. I even zone out at the computer, is it the meds, since I take no AD meds, no, is a lacck of stimulatiion i do not know, but until this bastardly disease took hold really hard in the last year, i sleep anywhere no matter how much I sleep at night. No one has a real answer because no one really knows this disease period, no matter who they are, except those of us that walk in it. GoD bless you and your familly,
About Aricept. My dad started on that when he first got Alzheimer's about 5 years ago. Aricept is a strange drug, please read the side effects. Dad is now on Memantine and was on the execelon patch. I found both of these memory drugs far better than Aricept, which caused him not only sleeplessness, but also horrible mood swings and outbursts of anger. Ask your doctor, perhaps it is time for your mom to switch her memory meds, personally I noticed the Aricept causing very disturbing behaviors in my dad, and after being off for only a day or two these behaviors stopped.
About the sleeping, it is vital to have your loved one on a routine that involves movement (exercises and stretching) and cognitive work, including reading together or puzzles. Any senior center that has Alzheimer patients can tell you some things you can do to help them stay in the moment, (and realize that they forget so much that remaining in the moment is important), stay active and participate socially. Day sleeping can lead to not sleeping at night. My dad has gone 3 days and nights without sleeping in the past. This landed him in the ER or the psych ward very confused. Activities and a structured day with a definitive bed time will help your loved one sleep at night.
I believe a nap is OK sometimes before or after lunch. However, if he/she sleeps too long it will totally confuse their inner clock. And if they wake up when sundowners starts it is all the worse. Keep naps short if possible.
Finally, medications have a way of helping one thing but depleting the body of others. My dad is on 1500 mg of good fish oil a day. He also takes Coenzyme Q10, which helps especially if the patient is on a statin for cholesterol. 200 mg 2 times day, this is also one really important supplement in that it is believed to slow down the aging process, including the brain!
Vitamin D, K2, Gamma E, Ester C and a Centrum for seniors are all also part of what I give my dad.
I have much more to write to you all, but this is the time when my dad gets up to say good night to me for hours. I need to get off the computer and get into my bed so he can SEE it is bedtime for him as well as me.
Good luck and be patient. Get your rest as a caregiver and give yourself a break, take a walk each day, whatever it is. We cannot help our loved ones if we are burnt out! It is not an easy job, but each time my dad smiles or remembers something it makes my day worth it.
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