How can I get sleep when my husband is up all night?

Ready for flight asked...

Recently my husband, 91, has started sleeping through the day and becoming very active at night. I understand that many dementia patients do this, how should I handle it to get some uninterrupted sleep for myself?

Expert Answer

Ron Kauffman is a certified senior advisor (CSA), senior lifestyle radio host, syndicated newspaper columnist, and the author of Caring for a Loved One With Alzheimer's Disease. In addition, Kauffman is also the primary caregiver for his mother, who has Alzheimer's.

I'm sorry to hear that your husband's symptoms of nighttime activity have increased and are now impacting your health as his caregiver. I will assume that your husband has dementia, since you indicated your awareness that other dementia patients show similar behavior.

Sleeping problems experienced by individuals with Alzheimer's and caregiver exhaustion are two of the most common reasons people with Alzheimer's are eventually placed in nursing homes. Some studies indicate that as many as 20 percent of persons with Alzheimer's will, at some point, experience periods of increased confusion, anxiety, agitation and disorientation beginning at dusk and continuing throughout the night.

I'm assuming that what your husband is demonstrating as a behavior is called sundowning. That's a condition common to many dementia patients, and indicates similar behavior to your husband's "“ increased inactivity and sleeping through the daytime hours and increased activity and agitation in the evenings, sometimes throughout the night.

Your question is how should you handle this behavior? The answer is that you can't handle it per se. It's a medical condition typical of dementia patients. There are a number of possible actions you can take, but none will cure his sundowning.

First, have your husband reevaluated by a geriatric neurologist who specializes in dementia and Alzheimer's treatment. The doctor will determine if his condition is sundowning or related to other possible conditions that may be medically treated and may try some prescription medications that will help your husband sleep at night.

Add to that a strong effort on your part to keep your husband engaged and busy with daytime activities. Perhaps taking him to an adult daycare or senior center would help keep him awake and active, thereby reducing his energy and alertness at night.

If neither the use of medicines nor attempts to increase his daytime activity level works, and it's possible that they will not be successful, you have a few other options you may consider. One is moving your husband into a separate bedroom in your home and hiring a caregiver to come in and be with him every night. During those hours, her job is to stay awake to care for your husband and keep him safe. Your job is to get some uninterrupted sleep.

The next option you might consider requires making a very difficult choice. You might consider placing your husband in a dementia specific assisted living facility. I would only recommend this approach if nothing else works, his overall mental and/or physical condition continues to decline, and you have the financial ability to pay for his care.

Most of us would prefer to spend our final years in the familiar setting of our own homes, but the reality for caregivers of dementia patients is that the tasks and demands are overwhelming, and often exceed our abilities.

This is particularly true with older couples. The fact is that if you, as your husband's caregiver, do not take care of your own health first, you will, over time, become a casualty of stress, loss of sleep and declining personal health. At that point, you are no longer a caregiver, but a patient. Too often the overstressed caregiver predeceases the patient, and that is not an option you want your husband or family to have to face.

I suggest you talk with your husband's doctors, also call your local Alzheimer's Association and other senior service providers to determine what assistance or services might be available to you. Then, armed with all of this information, discuss your options with your family. As difficult as it may be, choose the path that will best serve and protect your husband and allow you to remain healthy, active and part of his life.

I wish there were better answers. If you have access to a computer, I suggest you go to the following link to read what the professionals at the Alzheimer's Association say and suggest regarding sundowning.

Best of luck.