Dealing with the Patient's Sleep Deprivation
Lack of sleep makes everything worse. When patients don’t get enough rest or adequate sleep cycles, physical and mental problems are magnified. Caregivers, who may already be stressed, may be puzzled by changes in the patient’s mood, energy level, or pain tolerance. Learning to recognize the signs of sleep deprivation can address issues early and help the patient return to a natural sleep pattern and caregivers can sleep better, too!
Let’s look at the amount of sleep disruption in three groups:
1. ELDERLY PATIENTS: A study of 9,000 people over age 65 by the National Institute of Aging showed that over half reported at least one chronic complaint about their sleep.
2. ALZHEIMER’S AND DEMENTIA PATIENTS: Multiple studies show that 25-35% of these patients have sleep disorders. In middle-to-late stages, patients may have “Sundowners Syndrome” in late afternoon and early evening; they may become more confused and agitated than during daylight hours.
3. CANCER PATIENTS: University of Pennsylvania reports that 30-50% of cancer patients have trouble sleeping. Pain, nausea, chemotherapy, radiation, and hormonal therapy are some possible causes.
While each group has a different cause, the result is the same: Poor sleep quality leads to less total sleep time and an interruption of the natural “circadian” or daily patterns. Each group shows similar signs of sleep deprivation:
• Trouble falling asleep
• Trouble staying asleep
• Early-morning waking
• Daytime fatigue and napping
Caregivers should be alert for any of these signs and report them to the patient’s provider for early intervention. The provider can do an evaluation of possible factors, such as medications, sleep apnea, restless-leg syndrome, pain, or other medical conditions. Don’t assume that poor sleep is normal for the patient’s age or diagnosis.
Some ways to help the patient return to a healthy sleep pattern:
1. Establish and keep a wake-sleep schedule. Going to bed at the same time helps the brain know when it’s time to sleep.
2. Limit naps to 30 minutes and not after 3 pm.
3. Create a bedtime ritual, such as a bath or shower, warm milk, chamomile tea, relaxing music, or deep breathing.
4. Avoid alcohol, caffeine, and stimulating activity for six hours before bedtime.
5. Evaluate diet for heavy or spicy foods at dinner as possible factors.
6. Make sure the patient puts on nightclothes, to reinforce the idea of sleep.
7. The room should be dark and quiet, without bright clocks or electronics.
8. Settle the patient into a comfortable bed, not a recliner chair or sofa.
9. Consider herbal sleep aids, such as melatonin, if provider approves.
Sleep is a necessary human function. When it is compromised, even for a few days, behavior and physical symptoms can worsen. Don’t hesitate to report your observations, so that the patient can get proper rest...and so can you!
