Americans are more sleep-deprived than people in other countries. According to the National Sleep Foundation, most adults need between seven and nine hours of sleep each night for optimum performance, health, and safety. The Foundation advises: “When we don’t get adequate sleep, we accumulate a sleep debt that can be difficult to “pay back” if it becomes too big. The resulting sleep deprivation has been linked to health problems such as obesity and high blood pressure, negative mood and behavior, decreased productivity, and safety issues in the home, on the job, and on the road.”
Caregivers often find themselves exhausted at the end of the day, but many are still not able to sleep. Varying studies have documented that approximately 70% of caregivers for people with dementia report sleep problems, 60% report sleeping less than 7 hours, and 10-20% use alcohol to go to sleep and/or sleep medication. In data collected by the California Caregiver Resource Centers, 41% of caregivers said they are awakened during the night by the care receiver. These same caregivers also scored higher on the depression screening.
Insomnia comes in several forms—trouble falling asleep (more than 30 minutes), trouble falling back asleep after waking at night (e.g. to use the bathroom or care for someone else), waking up early and not being able to fall back asleep, or waking up not feeling refreshed. People with depression and anxiety also have a higher incidence of insomnia.
People with Alzheimer’s disease and other dementias frequently have sleep disturbances. The most common is “sundowning,” so called because the person gets agitated later in the day and often has trouble falling asleep and/or staying asleep once in bed. This leads, of course, to lack of sleep in caregivers, and is one of the most common reasons for a caregiver to place a care receiver in a facility. Lack of sleep also makes people irritable and impatient, which makes caregiving even harder.
It is important to talk with your loved one’s physician about sleep disturbances. This is as important for your loved one as it is for you and your health. You might consider a night time attendant or ask for respite help at night, so you can get sleep. Medications might help also. A rule of thumb is that you need a good night’s sleep every third night to prevent burn-out.
There are a number of ways to help yourself get a good night’s sleep. Getting exercise everyday is good for you in every way, but in particular, it helps with sleep and in reducing depression. Having a regular sleep routine—one that is calming, e.g. taking a bath or reading—and a regular bedtime are also important. Having a room that is dark, quiet and a little cool, and not eating a big meal before going to sleep, make a big difference. We all know to cut down on caffeine (and don’t forget many sodas contain caffeine), and also that alcohol may help you fall asleep, but may actually contribute to waking up during the night.
The National Institutes of Health have published a free booklet called “Your Guide to Healthy Sleep” which can be downloaded from their website, www.nih.gov or by writing to National Institutes of Health (NIH), 9000 Rockville Pike, Bethesda, MD 20892. Other helpful websites are: National Sleep Foundation, www.sleepfoundation.org; American Academy of Sleep Medicine, www.aasmnet.org; and National Center on Sleep Disorders Research, www.nhlbi.nih.gov/about/ncsdr/index.htm. A recent book that takes a comprehensive look at sleep issues and solutions is Arianna Huffington's The Sleep Revolution: Transforming Your Life, One Night at a Time (Thorndike Press, 2016).
Getting a good night’s sleep is not only necessary in order for you to take care of yourself, it is also necessary in terms of the quality of care you give your loved one. It should go at the top of your priority list instead of at the bottom where we usually find it!