Dementia is exhausting and affects sleep in various ways

My mother takes care of my grandfather. She’s concerned that he sleeps more than 20 hours a day. She is able to get him up, bathed, and into his recliner each morning but he almost immediately falls asleep again. He barely eats, doesn’t want to interact with her or anyone else who comes in to help, and doesn’t even watch television anymore. How can we motivate him to stay awake and interact?

You do not say how long ago your grandfather was diagnosed so it is difficult to know what stage of dementia he is in. If an individual is in the later stages of dementia and they have gradually begun sleeping longer periods of time, it is most likely due to the progression of the disease.

At the later stage of the disease, the damage to the person’s brain is quite extensive causing them to become weaker and quite frail. What we might consider relatively simple tasks, such as communicating or eating, can be utterly exhausting to the person with dementia.

If, however, the long periods of sleeping have started suddenly, there may be another cause such as an infection. Some medications can also contribute to sleepiness (antipsychotics, antidepressants, antihistamines). Sleeping disorders, such as sleep apnea (breathing difficulties), can also contribute to sleep issues. Do not hesitate to contact his physician with any of your concerns.

Some types of dementia can also affect sleep patterns. Individuals diagnosed with dementia with Lewy bodies have very restless and disturbed nights. They may experience confusion, nightmares, and hallucinations. Insomnia, sleep apnea and restless legs are also common symptoms. A person affected Parkinson’s disease may often unknowingly ‘act’ out their dreams, sometimes causing injury to themselves and/or their sleeping partner.

This can be exhausting and often leaves the person feeling like they have not slept at all. For both those living with Lewy body dementia and Parkinson’s disease, staying awake during the day after a poor night’s sleep can be difficult. If possible, it is best to try to limit sleep during the day to small bursts or ‘catnaps.’ Otherwise, the person’s body clock can become very confused and this makes sleeping well during the night even harder.

For her own peace of mind, your mother should speak with your grandfather’s physician and share her concerns.

I care for my husband who has Alzheimer’s disease. Is it common for individuals with Alzheimer’s to have hallucinations? He keeps talking about children being in the house; our children are all grown up and live elsewhere.

Hallucinations are defined as false perceptions of objects or events

involving the senses. Some individuals living with Alzheimer’s disease and other dementias may see, hear, smell, or feel something that is not there. These false perceptions are caused by changes within the brain. Some hallucinations may be frightening to the individual, but others can be rather ordinary visions of people or situations.

If your husband is merely curious about the children he sees, you might reassure him that “their mother is on the way to get them.” If he appears frightened or agitated, react calmly, and reassure him that you are going to protect him. Gently rubbing his back or stroking his hands may redirect his attention to you and reduce the hallucination. If he asks if you see the children, you can respond with “I know you see them, but I can’t.” Don’t tell him there is nothing there; to him, at that moment, they are very real. Acknowledge how it feels, whether it is worried, frightened, or angry.

Use distractions; suggest a walk or move to another room; use music or another activity to divert his attention. Check the environment; noise from television might be misinterpreted. Turn on lights to reduce shadows; cover mirrors if your husband no longer recognizes himself.

Always keep his physician updated on any changes, including hallucinations, so that he/she can determine if medication is appropriate.