Lamy Center Caregiver Connection: Getting a Good Night’s Sleep

Written By: Rudi Lamy, MLS, MAS, Consultant to the Peter Lamy Center on Drug Therapy and Aging

As I write this, I am in desperate need of a good night’s sleep. Just a few days ago, I tried to open the front door of my house with my car remote. Not only did my home not open to me, my car alarm went off as well, as if it were mocking me.

Despite this embarrassment, I know that the chances of me getting the rest that I need are currently slim to none.

Pardon Me Doc, But I Think I’m Seeing Things

There a many causes of sleep deprivation and insomnia for a caregiver like me — stress, either physical or emotional; depression or anxiety; on-call duties; greatly increased personal responsibilities; sundowning; changes in your loved one’s sleeping habits; and pain or great discomfort from illness or disease, just to name a few. I have experienced a number of these predicaments, yet I take some solace in the fact that I am not alone in this plight.

According to the Family Caregiver Alliance’s Seeking That Elusive Good Night Sleep, approximately 70 percent of caregivers for people with dementia report sleep problems. In addition, 60 percent report sleeping less than seven hours, while 10-20 percent report using alcohol or sleep medication to help fall asleep. Data collected by the California Caregiver Resource Center also finds that 41 percent of caregivers report being awakened during the night by the loved one for whom they are caring.

Not long after I assumed responsibility as my wife’s caregiver, I noticed that, every so often, I would see things that were not really there – people, mostly. According to my wife’s neuropsychiatrist, sleep deprivation causes my eyes to see things that my brain then tries to interpret as something familiar in my life, such as people on my front porch, even though what I am seeing is just a figment of my sleepy imagination.

However, lest you think that seeing famed English actor and The Invisible Man himself, Claude Rains, on my front porch is the most troubling side effect that I have experienced as a result of sleep deprivation, please continue reading to allow me to disabuse you of that notion.

The Pharmacology of Dementia, Caregiving, and Sleep

In addition to seeing people who are not really present, sleep deprivation can contribute to a wide range of other adverse effects.  For example, after one night of getting no sleep at all, I committed an error while taking my morning medications. While I did take morning medications, the medicines I consumed were not mine. Instead, in my sleep-deprived state, I took my wife’s medication by mistake.

Fortunately, I was incredibly lucky and nothing untoward happened, besides the panic attack I had after realizing my error.

The faculty of the Peter Lamy Center on Drug Therapy and Aging work at the University of Maryland School of Pharmacy and with other organizations, such as the American Society of Consultant Pharmacists, to educate patients and family members about steps we can take to improve in-home medication use and safety. But, accidents will still happen sometimes, as these health care professionals cannot physically be with us all day, every day, protecting us from ourselves.  In the long run, medication safety comes down to us as caregivers. This is true not only at home, but also if our loved ones have been hospitalized or moved to memory care in an assisted living facility. A good night’s sleep will help keep the mind sharp and less subject to making or better able to recognize medication errors, as well as other health care errors.

The Diurnal Caregiver and the Nocturnal Patient

According to the Alzheimer’s Association, people with Alzheimer’s disease and dementia may experience changes in their sleep schedule.

As part of our therapy regimen, my wife and I have had the good fortune to regularly consult with a clinical social worker as part of our hospital’s neuropsychiatry program. During those visits, I have discussed the complete reversal of my wife’s sleep schedule.

Similar to most people, I am diurnal: I work during the day and sleep at night. My wife, a patient coping with a more than decade-long struggle with dementia, has become nocturnal. It’s killing me.

Our social worker has taught me some non-drug strategies that were originally developed by the Alzheimer’s Association to help manage this shift. However, it remains a losing battle for me. My wife is asleep at 9 a.m., and awake at 3 a.m., all while being completely unaware of the time difference.

There are medications available for both caregivers and patients that can help resolve this change in sleep schedules. Some are available over-the-counter, such as melatonin. Others are available by prescription. Check with your physician and pharmacist to be sure that these medications will not cause any dangerous interactions with other medications that you might be taking.

Additional Resources to Help Recapture a Good Night’s Sleep

If you are a caregiver searching for online resources that offer some strategies that might help you and your loved one get a good night’s rest, I recommend checking out the following:

• A Good Night’s Sleep: Developed by the National Institute on Aging (NIA), this website provides a variety of strategies and resources that might help you fall asleep at night. It includes information about sleep and aging, sleep apnea, movement disorders and sleep, and Alzheimer’s disease and sleep.
• Sleep: Another website developed by the NIA, this resource aims to teach visitors how to get a good night’s sleep with tips on when to go to bed, the best time to exercise, and how to not let a nap ruin a night.

As a caregiver, you need your sleep. Always remember that you cannot take care of them if you don’t take care of yourself.

Thanks for reading.

Now go get some sleep.

Rudi Lamy – An Exhausted Caregiver