Alzheimer’s is a disease that slowly and progressively destroys cells in the brain that leads to the loss of intelligent reasoning and the ability to remember.
Researchers have indicated that disrupted sleep patterns may be one of the earliest signs of Alzheimer ‘s disease (even before any memory loss is noticed). It seems to go in both directions; plaque buildup on the brain disrupts sleep, and long periods of sleep deprivation generate plaque on the brain that leads to Alzheimer’s Disease.
Washington University conducted experiments with mice regarding sleep patterns and brain plaque. The results indicated that as soon as plaque begins to form on the brain, sleep was decreased*.
In persons already diagnosed with Alzheimer’s disease, sleep patterns have already been severely affected and will worsen over time. Scientists do not know exactly why sleep is disturbed, but some contributing factors may include depression, anxiety and restless leg syndrome.
Sleep patterns may naturally change as we age (and not due to dementia), but sleep disturbances will be more severe and happen more often when the disease is present.
Natural (non- medicated) treatments for sleep disruption in Alzheimer patients:
It is always encouraged to try as many natural treatments to induce sleep before using any type of prescribed medications.
It is important to keep to a schedule, including preparing for bedtime, and getting up at the same time every morning.
Physical exercise is encouraged in persons with Alzheimer’s’ Disease, but should not be performed in the evening (within four hours of a bedtime routine).
Stimulants such as caffeine, alcohol and nicotine should be avoided as much as possible.
Medications such as Donepezil or Tacrine or another cholinesterase inhibitor should be administered early in the day and not in the evening before bedtime.
Temperature in the bedroom should be comfortable, not too hot or too cold, to help promote a restful night’s sleep.
Physical pain limits people from resting properly, so treat* pain accordingly.
Prescription medication for changes in sleep patterns:
There are times when medication is required. Experts agree that when using non-natural sleep methods to begin using the lowest dose possible.
It is also important to ask the following questions when considering a new drug:
- Are there risks involved with taking this drug?
- Are other treatment options available?
- What are the positive benefits of taking this particular medication?
Some medications that help with sleep include, but are not limited to:
- Antidepressants such as trazodone and nortiptyline
- Zolpidem is a recommended sleeping pill
- An Atypical antipsychotic such as quetiapine and resperidone has been known to be helpful
Side effects with medication used to help with sleep are increased in elderly people, and it is encouraged that once sleep patterns have returned to normal that prescription medications be stopped.
Although not every Alzheimer’s patient will experience all the stages and some may overlap, below we have outlines the seven stages of Alzheimer’s disease and what the patient and caregiver should expect.
1. First Stage
At this point, there is no memory loss and no signs of dementia are noticeable by a medical professional or by friends and family.
2. Second Stage
This stage is noticed by the individual only and could be just part of the natural aging process or it could indicate early signs of dementia. There is no memory loss, but memory lapses such as where a familiar object is located. Friends, family or a complete physical exam would not indicate any symptoms that point to Alzheimer’s’ Disease.
3. Third Stage
It is at this stage that co-workers, family and friends will notice changes, and that an individual is having some difficulties, such as finding the right word to complete a sentence, forgetting where they put a valuable item (such as jewelry) or not being able to plan activities that once was easy. It is also at this stage that a medical professional would notice a disturbance in concentration in the individual.
4. Fourth Stage
The fourth stage is considered to be “mild”, but a clear diagnosis can be made by a medical professional. Some symptoms during this stage may include:
- Paying bills will be very challenging
- An individual may become withdrawn, especially in large crowds or social gatherings
- A person may not be able to clearly remember their personal experiences and/or history
- They would not be able to mentally recite a difficult math problem such as counting downward from 100 in increments of 7’s
5. Fifth Stage
At this stage, there is a moderate decline in memory and individuals may require assistance with their day to day routines. Symptoms to be aware of at this stage could include:
- An individual is unable to recall the high school they attended, their phone number or home address
- They may need assistance in choosing clothing for the current season or a particular event
- They may have trouble with a mental test that requires them to count backwards from 20, 2 at a time
The good news is they should still be able to eat and use the toilet without assistance.
6. Sixth Stage
During the sixth stage, there is a continued decline in memory and certain personal changes may occur, but they still should be familiar with their own name. Some other symptoms noticeable at this stage may include:
- Patient will require supervision while dressing as they will try to put daytime clothing over pajamas or attempt to put the left shoe on the right foot
- Sleep patterns may completely change; sleep during the daylight hours and become restless and disruptive during the evening hours
- They may wander away and easily get lost in the neighborhood
7. Seventh Stage
This is considered to be the final stage of Alzheimer’s disease, and patients will become unresponsive to their surrounding environment, and the ability to conduct a comprehensive conversation is extremely limited.
It is at this stage that an individual will need total assistance in eating, dressing and using the toilet.