One Page Sleep Disruption Intervention Sheet

Sleep disruption is one of the most common causes of care-partner burnout.

Disordered sleep affects approximately 44% of people living with Alzheimer’s Disease or Frontal Temporal Degeneration (FTD), and 90% of people living with Parkinson’s Disease or Dementia with Lewy Bodies (DLB).

Sleep disturbances are not always related to the progression of dementia, or may not be solely attributable to brain change. This is a complex symptom that requires holistic treatment. It may take a team to identify and troubleshoot the underlying concerns. Some common causes of sleep disruption can include: ● Obstructive Sleep Apnea* ● Depression or other mood disorders* ● Pain* ● Physical inactivity ● Lack of exposure to sunlight and fresh air ● Lack of cognitive stimulation *These are the three most common physical causes of sleep disruption The treatment of sleep disruption involves a multi-pronged approach which may include a medical consult to rule out physical conditions, adjustments to routine and environment, and (possibly) medications. Some next steps may involve: ● Ruling out and/or treating: medication side effects, restless leg syndrome, sleep apnea, REM sleep behavior disorder, hypersomnia, mood disorders like depression, and acute illnesses (especially when a sudden change in pattern occurs) ● Working with a physical and/or occupational therapist to support a routine tailored to strengths ● Building a routine for cognitive and social engagement during the day (Many complimentary programs are available online and are specialized for individuals living with dementia) ● Massage and aromatherapy to reduce stimulation and support relaxation in the evening ● Adapting the physical environment. An occupational therapist can make recommendations to optimize sleep hygiene, the pre-sleep routine, and the sleeping space ● Some adaptations may include: ○ Adding a white noise machine ○ Positioning for optimal comfort

©2021, Inspired Memory Care, Inc.

The environment can impact circadian rhythms through the signals it sends.

We as care-partners have the opportunity to create supports within the routine and environment for the individual to have better sleep patterns. To support: ● Stick to a consistent wake-up time (this is more important than a consistent bedtime) ● Incorporate moderate exercise into the routine (this is demonstrated to increase endorphins, easing arousal, anxiety and depression) ● Get outside! (exposure to natural light and fresh air has been proven to be highly effective to reset the body clock) ● Give moments of rest (overexertion can have the opposite intended effect on an individual) ○ Key considerations for rest during the day include: ■ Too many cat naps during the day, which can lead to a sleep disruption at night ■ A 90 minute nap can support the body to go through a complete cycle of REM sleep and prevent disorientation upon waking (2-3 pm is a great window for an afternoon rest) ● Ensure the environment has orienting cues, for instance, open blinds for sunlight throughout the day ● Ensure there is a dark sleeping space or use a red night light if a person has fear of a dark environment ● Finally, assessing an individual’s pre-bedtime nutrition habits can help.

Some guidelines include: ○ Minimizing chocolate and coffee consumption after 4:00 pm (even decaf has caffeine!) ○ Minimizing consumption of sugary foods (unstable blood sugar can compromise quality sleep and result in cravings) ○ Limiting refreshments less than an hour before bedtime and keeping them small ○ High fat, spicy and heavy meals can cause heartburn and activate digestion ○

The following foods may promote sleep by acting on or producing hormones like tryptophan, folate, serotonin, and melatonin: ■ Whole Grains, hummus, turkey ■ Dairy Foods (including yogurt, eggs and cheese) ■ Peanut Butter, nuts and seeds ■ Bananas, Pineapple, tart cherry juice

©2021, Inspired Memory Care, Inc.