Good sleep is a pillar of overall wellbeing. Whether our aim is to enhance mental health, prevent stroke, or boost our immunity, we must prioritize consistent rest — seven to nine hours is the gold standard — so that we can see the results we want.

“Sleep is as important as air and water,” says Patti Kodzis, a nurse practitioner who specializes in working with older adults.

Despite its significance, however, restorative slumber can feel incredibly elusive. Weaker bladders and a cornucopia of medication are among the reasons that many older adults face fragmented sleep.

Introduce dementia-related changes, however, and that quality shut-eye we crave may no longer feel possible. That’s because the person navigating symptoms is also experiencing shifts in their circadian rhythm, and the Care Partner might be experiencing anxiety related to their role.

“As the person with dementia progresses, then it affects the Care Partner’s sleep significantly,” Kodzis says. “They can’t sleep if their loved one is up at night pacing, [or if there is] risky behavior.”

Despite the challenges, there are several ways to improve sleep for both parties.

“Melatonin is a sleep hormone. You’ve got to support your melatonin level,” Kodzis says. “At night, you want dim lights. No watching TV right before bed.”

Kodzis notes that television programs stimulate the mind, which is not what we want when we’re getting ready for bed.

She also suggests that Care Partners rise no more than an hour before their person, drawing the blinds so that the room fills with morning light.

Those living with Alzheimer’s or some other expression of dementia should not indulge afternoon naps, either, if possible, Kodzis says.

If sundowning is an issue, Kodzis suggests creating a relaxing routine around that timeframe. Maybe everyone wears their pajamas, and watches a goofy television show.

“[Ask yourself] what’s the most anxious time for your loved one, and that’s when you start setting the routine,” Kodzis says.

Patti Kodzis

Care Partners may worry that their person will experience incontinence or a fall, prompting lighter sleep.

Kodzis suggests incorporating adult briefs into the routine and changing them the next morning.

“If they secure their home environment well [with] alarms on the door, and they know their loved one won’t exit at night, that is helpful,” Kodzis says.

“If depression or anxiety gets under control a little bit, medication wise, that will also help the sleep in the end,” she adds. “And the other thing that we look at very closely is I will look at the medications they are taking. Sometimes retiming medications can make a huge difference.”

Medication side effects can include insomnia, sleepiness, or vivid dreams, so if sleep struggles are an issue, Kodzis recommends seeking guidance from a doctor.

Kodzis says that Care Partners and the people navigating cognition changes often visit her when they’re early in the journey. It’s critical to rule out things like sleep apnea.

“What’s good for your heart is good for your head,” Kodzis says. “If you’re not getting the oxygen, you’re going to have potential death of tissue, but certainly impairment.”

A person who snores, wakes frequently, or is chronically foggy, even after eight or more hours of sleep, could be experiencing sleep apnea and should see a doctor.

It’s also critical to see a professional if you or someone you love is acting out their dreams, to rule out REM behavior disorder, which is linked to Parkinson’s and Lewy Body dementia.

See a specialist, too, if your partner is kicking so hard you can’t stay in bed, or if they are having full conversations while they are half awake.

Ultimately, our sleep is an essential piece of our health puzzle, so if we feel like it’s missing, it’s important to seek support so that we can experience some relief.