Dementia and Sleep Disturbances

Sleep Disturbance in Dementia

• Up to 25% of people with mild to moderate dementia and 50% of people with severe dementia experience sleep disturbances.
• Lauren, a person with dementia, exhibits agitated behavior during the day and wanders around the house at night, but does not show signs of hallucinations or Parkinsonism.

NCSD (Non-Cognitive Symptoms of Dementia)

• NCSDs affect people with dementia and include agitation, aggression, disinhibition, delusions, hallucinations, anxiety, apathy, wandering, and repetitive actions.
• Most NCSDs will resolve themselves within a 4-week period, so "watchful waiting" is recommended.
• Pharmacological approaches have limited effectiveness and can have harmful side-effects, so non-pharmacological interventions should be prioritized.

Interventions for NCSD

• Indirect interventions target caregivers and the environment, including caregiver training, multidisciplinary team approaches, individualized treatment plans, and modifying environmental factors.
• Direct interventions target individuals with dementia, such as art, music, physical exercise, meaningful activities, life story discussion groups, and Cognitive Stimulation Therapy (CST).
• CST is a talking therapy that improves quality of life and maximizes available cognition in people with mild to moderate dementia.

Bio-Psycho-Social-Physical Perspective

• An integrated approach considers biological, psychological, social, physical, and environmental factors for effective management of NCSD.

Person-Centered Care

• Focus on the whole person, not just the disease.
• Get to know the person with dementia, recognize and accept their reality, and support ongoing opportunities for meaningful engagement.
• Build and nurture authentic, caring relationships and create a supportive community.

Caregiver Support

• Family carers play a central role in caring for people with dementia and need support to develop their skills and address their own emotional and practical needs.
• Recommendations include dementia-specific training, carer support, and address the risk of depression among carers.

Communication

• Good communication skills are essential in supporting people with dementia.
• Techniques include creating a calm environment, speaking clearly, and respecting the person's perspective.

Environmental Design

• A well-designed environment can reduce NCSD, improve orientation, and reduce behavioral disturbance.
• Key principles include reducing crowding and noise, using clear signage, and providing easy-to-use toilets.

Pharmacological Intervention

• Prior to considering psychotropic medication, a comprehensive assessment must be performed.
• Antipsychotics may be indicated for agitation, psychosis, and aggression, but risks and benefits must be fully explained to the patient and/or caregivers.

A quiz about sleep disturbances in people with dementia, particularly in those with mild to moderate and severe dementia. Learn about the common symptoms and possible causes of sleep disturbances in dementia patients.