8. Night-time and sleep
Key points
- Poor sleep is very common for people living with dementia, and continence problems can make this worse.
- Some people need a different type of continence product at night.
- Sometimes the continence problems at night can’t be solved, but there are ideas which might make them easier to manage.
Some people living with dementia have poor sleep. Continence or toilet use problems can make this worse. For example, some people have incontinence whilst they are asleep; others need to use the toilet many times each night and might need support each time.
General advice on how to manage sleep problems and ‘sundowning’ (when someone with dementia is more restless or confused in the late afternoon or evening ) can be found on the Alzheimer’s Society website (www.alzheimers.org.uk).
Night-time problems can be very tiring for both the person and their carer. There are often no easy answers, but there are some things that might make it easier to manage. There are ‘Things to think about’ in the section below. Also look at sections 4 and 6 for more ideas.
“She only uses [wrap-around diaper style product] overnight mainly it’s because if I feel sometimes she might go to bed at 6 pm and I know if she’s going to go 14 hours then it’s best to have a bit of extra security.”
Husband
Things to think about
- Avoid caffeine after midday (some people might need to avoid it completely). Drinks and food containing caffeine include coffee (even some decaf), tea, energy drinks, chocolate and cocoa.
- Make sure the person has plenty to drink during the day but reduce the amount 2-3 hours before bedtime.
- Night-lights with motion sensors could be useful to help keep independent and safe.
- Mattress, duvet and pillow protectors are available. Disposable or washable bed pads can be used on top of sheets. Disposable bed pads are plastic-backed and some people find them uncomfortable and might cause skin problems for some people.
- People who use continence products might find that the one type of product works well during the day, but leaks at night. For example, a man who sleeps on his side might need a product that absorbs pee at the sides. Most disposable products do not do this, but some washable products do.
- Some people find that pull-up products work well at night, for others wraparound products that are adjustable at the sides are better. See www.continenceproductadvisor.org for more information.
- Look for patterns. Are there any foods or drinks that make things worse? Or if the person is wetting the bed at a regular time, would it be better to set an alarm and take them to the toilet?
- Lack of sleep is bad for everyone’s health. If you can access respite care, night-sitters or residential care it might be helpful to get a break when you can’t get enough sleep.
“To begin with I had the towelling type sheets with the plastic backing on. We had a huge bed so one side of it could be a single mattress. Then I just couldn’t keep up with it and I got the hospital mattress.”
Wife