If your care recipient with dementia has trouble falling asleep or staying asleep, consider these non-pharmacologic approaches for improving sleep before or in conjunction with pharmacologic approaches.
- Encourage the person to use the bedroom for sleeping only. Discourage the person from staying in bed while awake, watching television, or reading.
- Establish a comfortable, familiar, and secure sleeping environment.
- Make sure the person’s bed and pajamas are comfortable.
- Maintain a comfortable temperature for the elderly, who tend to be more sensitive to cold.
- Have extra blankets available.
- Place security objects, such as a favorite blanket or stuffed animal, within easy reach.
- Make sure the room is quiet. Even quiet noises can be stressful to a person with dementia.
- Maintain a regular time and routine for going to sleep at night and rising in the morning. Try to make the evening hours relaxing.
- Try to limit naps during the day to no more than 20-30 minutes. Discourage naps in the late afternoon and evening.
- Schedule regular exercise; try to time it no more than 4 hours before bedtime.
- A snack prior to bedtime may help reduce awakenings during the night due to hunger.
- Reduce or eliminate the intake of caffeine, alcohol, and nicotine, especially in the evening. Reduce the intake of liquids just before bedtime.
- Make sure the path to the bathroom is well lit and clear. Leave a nightlight on in the bathroom. Make sure clothing is simple and easy to disrobe for using the toilet.
- If the person with dementia wakes up during the night, assume that s/he is disoriented and help orient and reassure her/him. Remind the person that it is time for sleeping. Find out if there is something s/he needs to help her/him go back to sleep.
- If the person with dementia awakens upset, offer reassurance that everything is all right and that everyone is safe. Speak softly and quietly using a relaxed tone. Consider using distraction.
- Bright light can help regulate the body’s biological clock (circadian rhythm). Seek sunlight exposure during the day. Bright light therapy using a light box may also help regulate the body’s biological clock.
- Try to manage pain symptoms as much as safely possible prior to bedtime.
- Consult a physician about any underlying health problems, pain management, and sleep problems if indicated.