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PUTTING THE DAY TO BED: ALZHEIMER'S & SLEEP

People with Alzheimer's disease often experience sleep disorders — especially as the disease progresses. Sleep problems affect not only their own health but also the wellbeing of their caregivers whose own sleep is frequently disrupted by their parent's nighttime wakefulness.

Understanding how and why sleep problems occur can help you develop strategies that will help everyone in your household enjoy a good night's sleep.

CAUSES OF SLEEP PROBLEMS
People with memory loss often become sleepy and nod off or nap throughout the day. As a result they have difficulty falling asleep at night and are more likely to wake up more often and stay awake longer at night. Depression, pain, physical illnesses that lead to sleep apnea, too much caffeine, boredom, certain medications, and lack of physical activity can also affect sleep patterns.

PLANNING THE DAY FOR A GOOD NIGHT'S SLEEP
Once families are aware of their parent's sleep habits they can plan a daily routine of activities to limit daytime napping. Walks, housekeeping chores, visiting friends, gardening, trips to the mall — even if it's only to window-shop — will keep your older parent active and alert during the day and tire him out so he can sleep soundly at night. Limit your parent's daytime TV viewing to a few shows that he or she really enjoys. It's easy to doze off watching re-runs of old sitcoms, soap operas or talk shows.

Consider enrolling your relative in an adult day program for a day or two each week. Day centers offer meals, snacks, and a variety of activities — art, exercise, music, outings — and the company of other people. Your relative will enjoy meeting new people will be pleasantly tired after a day or activities. While he or she is gone you can take a much-needed nap yourself!

TIME FOR BED
Create a bedtime routine that helps your parent prepare for a good night's sleep. Wind down at the end of the day by listening to soothing music, reading a poem or story, or praying together. Make sure he or she uses the toilet before pulling up the covers. Keep the bedroom at a comfortable temperature. Keep extra blankets handy in winter and a fan or air conditioner when the weather is warm. Install nightlights in the hall and bathroom to make it easy for your parent to find her way to the bathroom.

MEDICATIONS THAT AFFECT SLEEP
People over 65 take more prescription and over-the-counter medications than any other age group, according to the National Institute on Aging. It's not unusual for an older person to take 14 or more different drugs each day. Side effects of both prescription and non-prescription medicines can affect sleep especially in older adults. Some drugs may cause daytime drowsiness while others keep your relative wide awake at night.

If your parent has trouble falling asleep or staying asleep at night or is drowsy during the day ask the doctor or the pharmacist if her medicines could be affecting her sleep patterns. Alternative medications may be available that don't affect sleep.

Medicines that cause drowsiness:

Caffeine found in tea, coffee, certain soft drinks and medications that contain caffeine can keep your parent awake during the day and night. Limit his intake of caffeinated drinks during the day or substitute decaffeinated drinks. Alcoholic drinks also affect sleep.

Despite your best efforts your parent may still be unable to sleep. Her wakefulness may disturb the sleep of you and other family members. Ask the doctor if there are over-the-counter sleep medications that your parent may use occasionally when she can't get to sleep. The doctor can recommend those that are most effective and have the fewest side effects.

HOW SLEEP PROBLEMS AFFECT CAREGIVERS
Your parent wakes up during the night, confused and upset. He may be cold, confused or need to go to the bathroom. You're tired from your daily round of caregiving chores and other activities, but be patient and reassuring with him, lead him back to bed, tuck him in and see if you can find out what's bothering him. Remind yourself that your relative has an illness and he isn't responsible for his behaviors and that you are now responsible for caring for him.

A version of this article appeared in the Private Health News.