Sleep disorders management

Sleep disorders are common in people with dementia, including sleep apnea, insomnia, rapid eye movement sleep behavior disorder and restless legs syndrome.
Sleep plays important roles in cognitive health. If you or your loved ones are experiencing sleep problems, talk to your doctor about seeing a sleep specialist for a consultation.

Common sleep disorders in dementia

Sleep apnea  
Sleep apnea causes your breathing to stop and start multiple times while sleeping. Left untreated, sleep apnea can compromise the quality of sleep, cause daytime dysfunction and negatively impact cardiovascular and brain health.
Treatment for sleep apnea includes lifestyle modification, sleep position therapy, oral appliances, positive airway pressure therapy and surgery.

Insomnia and circadian rhythm sleep disorders 
Insomnia (difficulty falling and/or staying asleep) and circadian rhythm sleep disorders (disruption in the body’s “internal clock”) are common in individuals with dementia. As dementia progresses, sleep difficulty tends to worsen, which can be stressful for patients and their caregivers. This can also cause nighttime confusion/agitation and daytime sleepiness.
A non-pharmacologic approach is the first treatment option that includes maintaining proper sleep hygiene and a regular sleep-wake schedule, minimizing daytime naps and increasing daytime physical activity and light exposure. If needed, medications can be considered.

Rapid eye movement (REM) sleep behavior disorder 
Rapid eye movement can lead people to “act out” their dreams while sleeping. People might yell, flail their arms and kick their legs while dreaming. Rapid eye movement is associated with Parkinson disease, dementia with Lewy bodies and multiple system atrophy.
Maintaining bedroom safety and medications like melatonin are typical treatment options for REM sleep behavior disorder.

Restless legs syndrome  
Restless leg syndrome causes an urge to move the legs especially in the evening and night. In severe cases, it can disrupt sleep and affect daily activities.
Treatment for restless legs syndrome includes lifestyle modification and medications.